Compression interlocking intramedullary nail system versus dynamic hip screw extramedullary fixation in the repair of Evans V intertrochanteric fractures in the elderly

Zhu Yong-chao

doi:10.3969/j.issn.2095-4344.2014.40.019

Abstract：BACKGROUND:There are many methods of internal fixation to treat intertrochanteric fractures. Intramedul ary or extramedul ary fixation remains controversial. As for biomechanics, intramedul ary fixation has more advantages compared with extramedul ary fixation. Whether intramedul ary fixation is better for treatment of Evans V type intertrochanteric fracture in the elderly? <br> OBJECTIVE:To compare the clinical effects of intramedul ary or extramedul ary fixation for the treatment of Evans V type intertrochanteric fracture in the elderly. <br> METHODA total of 47 patients with Evans V type intertrochanteric fracture in the elderly from Department of Orthopedics, Shenyang People’s Armed Police Corps Hospital from December 2010 to December 2013 were selected. They were separately subjected to compression interlocking intramedul ary nail system and dynamic hip screw system extramedul ary fixation. <br> RESULTS AND CONCLUSION:Patients in the dynamic hip screw group were averagely fol owed up for 12 months, and those in the compression interlocking intramedul ary nail group were averagely fol owed up for 10 months. Both groups reached bone healing during fol ow-up. After fixation, average operation time and intraoperative blood loss were less in the dynamic hip screw group than in the interlocking intramedul ary nail group (P<0.05). However, fracture healing time was significantly shorter in the anti-spin intramedul ary nail group than in the dynamic hip screw group. Moreover, Harris scores revealed that hip joint function was better in the interlocking intramedul ary nail group than in the dynamic hip screw group (P<0.05). In the extramedul ary group, nail loose exit was detected in one case, plate breakage in one case. In the intramedul ary group, screw loose was detected in one case. Results suggested that two kinds of fixation for treating intertrochanteric fracture achieved good therapeutic effects. However, for Evans V intertrochanteric fractures in a short period, compression interlocking intramedul ary nail fixation can make patients do weight-loading activities earlier before joint replacement, and hip joint function effects are better.