Effect of fracture collapse on quality of life after femoral intertrochanteric fractures treated by the dynamic hip screw

CHANG Bao-sheng; FENG Yang-yang; FU Wei-guang

doi:10.3969/j.issn.2095-252X.2017.03.006

Abstract：Objective To investigate the effect of dynamic hip screw ( DHS ) on the patient' walking ability, complication rate and survival time of the patients who suffered fracture collapse after femoral intertrochanteric fractures.Methods We retrospectively analyzed 386 cases with femoral intertrochanteric fractures of 31A1 or 31A2 by AO typing treated with DHS, who were divided into mild group, moderate group and severe group according to the degree of postoperative fracture collapse. The general information, prognosis and survival time of the 3 groups were compared.Results The results of univariate analysis showed that there were significant differences in the degree of fracture collapse with the age [ ( 67.8 ± 3.6 ) yeasvs. ( 67.3 ± 4.6 ) yearsvs. ( 72.5 ± 3.9 ) years ], fracture type ( A1: 58.3%vs. 33.6%vs. 30.9% ), distance from the best contact point to the vertex > 25 mm ( 0.4%vs. 8.7%vs. 0% ) and reduction quality (P < 0.05 ). There were significant differences in the postoperative walking ability of the patients with different degrees of fracture collapse (P < 0.05 ). There were significant differences in the incidence of postoperative complications of the patients with different degrees of fracture collapse, such as implant translation ( 0.8%vs. 5.4%vs.11.5% ), hip perforation and breakage ( 0%vs. 3.3%vs. 11.9% ), bone nonunion ( 0%vs. 2.2%vs. 14.3% ) and reoperation ( 0.9%vs. 2.4%vs. 11.6% ) (P < 0.05 ). The results of Kaplan-Meier analysis showed that there was no signiifcant correlation between fracture collapse and the survival rate at 2.5 - 7.4 years after operation. Conclusions Fracture collapse after femoral intertrochanteric fractures significantly affects the patients' walking ability, but has no significant effect on the survival time.