Comparative studies of three methods of DHS internal fixation for the treatment of osteoporotic intertrochanteric fracture

WANG Bin; Lv Haoran; WANG Weixiong; LI Shen

doi:10.3969/j.issn.1674-666X.2013.06.001

Abstract：Objective To compare the differences of clinical efficacy among 3 surgical methods for treatment of osteoporotic intertrochanteric fracture including conventional dynamic hip screw (DHS) fixation, bone cement augmentation with DHS fixation as well as allogeneic bone grafting with DHS fixation. Methods According to random number table, 90 elderly patients with osteoporotic intertrochanteric fracture treated in the Second Affiliated Hospital of Guangzhou Medical College from January 2010 to September 2012 were divided randomly into control group, bone cement group and bone grafting group, in which preformed DHS fixation, bone cement augmentation combined with DHS fixation, and allogeneic bone grafting with DHS fixation respectively. Differences of excellent and good rate of postoperative Harris score, time of fracture healing and the incidence of postoperative complications were compared among 3 groups. Results All patients were followed-up for 12 to 18 months, with the average of 14.8 months. Excellent and good rate according to Harris score was 93%, 80% and 70% in bone grafting group, bone cement groups and control group respectively, which showed the difference between control group and bone grafting group (P<0.05). Compared with control group and bone cement group, time of fracture healing in bone grafting group was shorter (P <0.05), and the incidence of postoperative complications (3%) was the lowest (27%, 10% in control and bone cement group respectively). Conclusions For elderly patients with osteoporotic intertrochanteric fracture, allogeneic bone grafting combined with DHS fixation may get satisfied clinical effect because of its advantages of good postoperative hip joint function rehabilitation, short fracture healing time, and less complications.