Comparison of the Therapeutic Effect of Intramedullary Fixation and Medullary External Fixation on Evans-Jensen Type Ⅲ Intertrochanteric Fracture_West China Medical Journal

Authors：

 XIAOLiu-bin , FUZhao-xia , WANGQing-hua , LAIJun-cheng , HUGuang-ping

Department of Orthopaedics, the People's Hospital of Longhua District, Shenzhen, Guangdong 518109, P. R. China;

Corresponding?author：

Keywords：

Intertrochanteric fracture; Dynamic hip screw plate; Locking compression plate; Gamma nail; Proximal femoral nail anti-rotation

DOI：

10.7507/1002-0179.20140613

Video：

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Objective To compare the therapeutic effect between intramedullary fixation and external fixation on intertrochanteric fracture. Methods Between June 2005 and June 2011, 32 patients with Evans-Jensen type Ⅲ intertrochanteric fracture were treated with proximal femoral nail anti-rotation (PFNA), Gamma nail, dynamic hip screw plate (DHS) or locking compression plate (LCP), separately. The operation duration, peri-operative bleeding, load time, Harris hip score and postoperative complications were observed in the patients, and were used to analyze the therapeutic effect among the four methods. Results Shorter operation duration, less bleeding in the surgery, smaller quantity of drainage after the operation (P<0.05) were found in group Gamma and group PFNA compared with those in group DHS and LCP. The duration of hospitalization didn't differ much between the two fixation systems (P>0.05). The difference in operation duration, operative bleeding and post-operative drainage between group Gamma and PFNA, and between group DHS and LCP was not significant (P>0.05). Conclusion The intramedullary fixation was better than external fixation for Evans-Jensen type Ⅲ intertrochanteric fracture.

Citation： XIAOLiu-bin, FUZhao-xia, WANGQing-hua, LAIJun-cheng, HUGuang-ping. Comparison of the Therapeutic Effect of Intramedullary Fixation and Medullary External Fixation on Evans-Jensen Type Ⅲ Intertrochanteric Fracture. West China Medical Journal, 2014, 29(11): 2023-2027. doi: 10.7507/1002-0179.20140613 Copy

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4.	邢彬. 鎖定加壓鋼板與股骨近端防旋髓內釘治療不穩定股骨轉子間骨折的臨床療效分析[J]. 中國醫師進修雜志, 2014, 37(14):42-44.
5.	Evans EM. The treatment of trochanteric fractures of the femur[J]. J Bone Joint Surg Br, 1949, 31B(2):190-203.
6.	郝偉, 王新, 周路綱, 等. 老年股骨轉子間骨折不同治療方法對比研究[J].中華實驗外科雜志, 2014, 31(6):1362-1364.
7.	陳勝偉. DHS和PFNA治療老年股骨轉子間骨折的臨床效果對比分析[J]. 甘肅醫藥, 2014, 33(7):543-545.
8.	柏冰, 侯志勇. 不同內固定方法在絕經后股骨轉子間骨折患者中的應用[J]. 海南醫學, 2014, 2(13):1921-1923.
9.	張曉銘, 鄒鵬. 2種不同方法治療不穩定型股骨轉子間骨折的比較[J]. 中國傷殘醫學, 2014, 22(11):47-48.
10.	江庭彪, 鄭豪芬. DCS治療老年股骨粗隆間骨折26例臨床分析[J]. 中國實用醫藥, 2011, 6(10):48-49.
11.	曾昭勛, 陳宗雄, 邱俊欽. 不同固定方法治療老年股骨轉子間骨折療效比較[J]. 臨床骨科雜志, 2011, 14(3):302-304.
12.	江偉, 劉躍洪, 楊靈, 等. 股骨近端鎖定鋼板與Gamma3治療穩定型股骨轉子間骨折的生物力學比較研究[J]. 中國修復重建外科雜志, 2014, 28(9):1095-1098.
13.	林楊景, 李杰, 林炎水, 等. InterTAN、PFNA和DHS治療股骨轉子間骨折的療效比較[J]. 暨南大學學報·自然科學與醫學版, 2014, 35(3):294-298.
14.	文浩, 段戡, 袁長深, 等. 股骨近端鎖定鋼板與動力髖螺釘修復股骨轉子間骨折的系統評價[J]. 中國組織工程研究, 2014, 18(35):5715-5722.
15.	章光峰, 張軍, 張明永, 等. 187例股骨轉子間骨折手術經驗總結[J]. 衛生職業教育, 2011, 29(11):129-132.
16.	楊國躍, 江漢, 韓立強, 等. PFNA治療老年外側壁不完整型股骨轉子間骨折的療效分析[J]. 天津醫藥, 2014, 42(7):713-715.

1. 馮濟陳, 張金福, 黃正霜, 等. 股骨近端鎖定鋼板加拉力螺釘治療老年骨質疏松性股骨轉子間骨折31例分析[J]. 浙江醫學, 2014, 8(13):1176-1177.
2. Canale ST, Beaty JH. 坎貝爾骨科手術學[M]. 11版. 王巖, 陳繼營, 周勇剛, 等, 譯. 北京:人民軍醫出版社, 2009:2358.
3. 王俊杰. 股骨轉子間骨折的不同手術治療效果分析[J]. 中國醫學工程, 2014, 22(6):25, 27.
4. 邢彬. 鎖定加壓鋼板與股骨近端防旋髓內釘治療不穩定股骨轉子間骨折的臨床療效分析[J]. 中國醫師進修雜志, 2014, 37(14):42-44.
5. Evans EM. The treatment of trochanteric fractures of the femur[J]. J Bone Joint Surg Br, 1949, 31B(2):190-203.
6. 郝偉, 王新, 周路綱, 等. 老年股骨轉子間骨折不同治療方法對比研究[J].中華實驗外科雜志, 2014, 31(6):1362-1364.
7. 陳勝偉. DHS和PFNA治療老年股骨轉子間骨折的臨床效果對比分析[J]. 甘肅醫藥, 2014, 33(7):543-545.
8. 柏冰, 侯志勇. 不同內固定方法在絕經后股骨轉子間骨折患者中的應用[J]. 海南醫學, 2014, 2(13):1921-1923.
9. 張曉銘, 鄒鵬. 2種不同方法治療不穩定型股骨轉子間骨折的比較[J]. 中國傷殘醫學, 2014, 22(11):47-48.
10. 江庭彪, 鄭豪芬. DCS治療老年股骨粗隆間骨折26例臨床分析[J]. 中國實用醫藥, 2011, 6(10):48-49.
11. 曾昭勛, 陳宗雄, 邱俊欽. 不同固定方法治療老年股骨轉子間骨折療效比較[J]. 臨床骨科雜志, 2011, 14(3):302-304.
12. 江偉, 劉躍洪, 楊靈, 等. 股骨近端鎖定鋼板與Gamma3治療穩定型股骨轉子間骨折的生物力學比較研究[J]. 中國修復重建外科雜志, 2014, 28(9):1095-1098.
13. 林楊景, 李杰, 林炎水, 等. InterTAN、PFNA和DHS治療股骨轉子間骨折的療效比較[J]. 暨南大學學報·自然科學與醫學版, 2014, 35(3):294-298.
14. 文浩, 段戡, 袁長深, 等. 股骨近端鎖定鋼板與動力髖螺釘修復股骨轉子間骨折的系統評價[J]. 中國組織工程研究, 2014, 18(35):5715-5722.
15. 章光峰, 張軍, 張明永, 等. 187例股骨轉子間骨折手術經驗總結[J]. 衛生職業教育, 2011, 29(11):129-132.
16. 楊國躍, 江漢, 韓立強, 等. PFNA治療老年外側壁不完整型股骨轉子間骨折的療效分析[J]. 天津醫藥, 2014, 42(7):713-715.

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West China Medical Journal

Comparison of the Therapeutic Effect of Intramedullary Fixation and Medullary External Fixation on Evans-Jensen Type Ⅲ Intertrochanteric Fracture

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