导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

Minimally invasive percutaneous compression plating versus dynamic hip screw for intertrochanteric fractures: a randomized control trial

Objective：Intertrochanteric femur fracture is a common injury in elderly patients.The dynamic hip screw （DHS） has served as the standard choice for fixation; however it has several drawbacks.Studies of the percutaneous compression plate （PCCP） are still inconclusive in regards to its efficacy and safety.By comparing the two methods,we assessed their clinical therapeutic outcome.Methods：Atotal of 121 elderly patients with intertrochanteric femur fractures （type AO/OTA 31.A 1-A2,Evans type 1） were divided randomly into two groups undergoing either a minimally invasive PCCP procedure or a conventional DHS fixation.Results：The mean operation duration was significantly shorter in the PCCP group （55.2 min versus 88.5 min,P＜0.01）.The blood loss was 156.5 ml±18.3 ml in the PCCP group and 513.2 ml±66.2 ml in the DHS group （P＜0.01）.Among the patients treated with PCCP,3.1％ needed blood transfusions,compared with 44.6％ of those that had DHS surgery （P＜0.01）.The PCCP group displayed less postoperative complications （P＜0.05）.The mean American Society of Anesthesiologists score and Harris hip score in the PCCP group were better than those in the DHS group.There were no significant differences in the mean hospital stay,mortality rates,or fracture healing.Conclusion：Due to several advantages,PCCP has the potential to become the ideal choice for treating intertrochanteric fractures （type AO/OTA 31.A1-A2,Evans type 1）,particularly in the elderly.     

Effect of dynamic hip screw on the treatment of femoral neck fracture in the elderly

[Abstract] Objective： To discuss the indications, surgical procedures, and curative effect of dynamic hip screw （DHS） in the treatment of femoral neck fracture in the elderly. Methods： A retrospective study was conducted to analyse the clinical data of 42 elderly patients who had been treated for femoral neck fracture with DHS in our department between June 2009 and November 2011. There were 21 males and 21 females with a mean age of 68.5 years （range 60-75 years）. According to the Garden Classification, there were 19 cases of type II, 21 cases of type III and 2 cases of type IV fractures. By the Singh In- dex Classification, there were 3 cases of level 2, 19 cases of level 3 and 20 cases of level 4 fractures. The Harris cri- terion, complications and function recovery after operation were analysed. Results： The average hospitalization time in 42 patients was 11.2 days （range 7-21 days）. All patients were followed up for 12-26 months （mean 18 months）. No lung infection, deep venous thrombosis or other complications occurred. Partial backing-out of the screws was found in 2 cases. The internal fixation device was with- drawn after fracture healing. Internal fixation cutting was found in 1 case, and he had a good recovery after total hip arthroplasty. The time for fracture healing ranged from 3-6 months （average 4.5 months）. According to Harris criteri- on, 15 cases were rated as excellent, 24 good, 2 fair and 1 poor. The Harris scale was significantly improved from 30.52＋2.71 preoperatively to 86.61＋2.53 at 6 months post- operatively （P〈0.05）. Conclusion： DHS, being minimal invasive, al- lowing early activity and weight-bearing, is advisable for treatment of elderly patients with femoral neck fracture. In addition, it can avoid complications seen in artificial joint replacement. It is especially suitable for patients with mild osteoporosis.