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[The comparison of three operation methods for treatment of femoral intertrochanteric fracture].

OBJECTIVE
To investigate the therapeutic effect on femoral intertrochanteric fracture for three kinds of treatment methods and make theoretical analysis to offer basis on choosing the proper treatment method in clinic.


METHODS
We retrospectively reviewed the clinical and radiological records of 198 patients with femoral intertrochanteric fracture for three kinds of different treatment: unilateral external fixation apparatus (51 cases), dynamic hip screw (57 cases), internal fixation of Gamma nail (90 cases) from January 2001 to October 2006. The union of fracture and weight loading time, the averages length of stay,the incidence of complications,the functional evaluation of hip joint (the rate of excellent and good results) were compared and the curative effects were analyzed in different methods.


RESULTS
All the patients were followed-up for 36 months in average (from 8 months to 51 months). The union of fracture time were no statistically significant among the three groups (P>0.05). The weight loading time and incidence of complications were statistical significance among the three groups (P<0.05). Among the three groups,the incision length, operation time,blood loss and drainage in dynamic hip screw group were more than other groups, the unilateral external fixation apparatus group were less, Gamma nail group were in moderate. According to the Sanders' hip functional standard score,there were significant difference between the Gamma nail group and the other two groups (compared with dynamic hip screw group, P<0.05; compared with unilateral external fixation apparatus group, P<0.01).


CONCLUSION
The internal fixation of Gamma nail is a good choice for treating femoral intertrochanteric fracture. The weight loading time is earlier,the recovery of hip joint function is better,the incidence of complications is less in Gamma nail group than other two groups.