[Comparison of proximal femoral locking plate and Gamma nail in the treatment of the femoral intertrochanteric fractures in the elder].

OBJECTIVE: To evaluate and compare the clinical effects of proximal femoral locking plate with Gamma nail in the treatment of the femoral intertrochanteric fractures in the elder.

METHODS: From June 2008 to June 2010, 83 patients with femoral intertrochanteric fracture were randomly divided into two groups(group A and group B). In group A,there were 42 cases including 23 males and 19 females, the range of their age was from 64 to 92 years old;according to Jensen classification, there were 19 cases of type II fracture,17 of type III fracture, 4 of type IV fracture, 2 of type V fracture. In group B,there were 41 cases including 24 males and 17 females, the range of their age was from 65 to 90 years old; 20 cases were type II, 16 cases were type III, 3 cases were type IV, 2 cases were type V. The patients of group A were treated with locking plate, the patients of group B with Gamma nail. The observing and comparing items of the two groups included (1) After the operation, the operational duration was assessed; (2) After the operation, intraoperative bleeding volume was assessed; (3) Hemoglobin reduction was assessed in second day after the operation; (4) At the last follow-up, fracture healing time was assessed. (5) Functional recovery was evaluated according to Parker and Palmer mobility score.

RESULTS: All patients were followed-up for 10.6 months in average (ranging from 8 to 12). In group A, the average operation time was (62.46 +/- 21.61) min, the range of intraoperative bleeding volume was from 50 to 260 ml, the average hemoglobin reduction after the operation was (18.20 +/- 6.25) g/L, the rang of fracture healing time was from 12 to 24 weeks and the average Parker-Palmer mobility score was (7.68 +/- 1.09) points. In group B, the average operation time was (67.42 +/- 19.46) min, the range of intraoperative bleeding volume was from 40 to 280 ml, the average hemoglobin reduction after the operation was (40.14 +/- 8.62) g/L, the rang of fracture healing time was from 14 to 22 weeks and the average Parker-Palmer mobility score was (7.59 +/- 1.12) points. There were no statistically significant differences (P > 0.05) between two groups for the average operation time,the volume of intraoperative bleeding and Park and Palmer mobility score. Hemoglobin reduction after the operation in group A was less than in group B, there were statistically significant differences (P < 0.05) between two groups.

CONCLUSION: The method of proximal femoral locking plate had advantages of less bleeding after operation and relative strong fixing in the femoral intertrochanteric fractures, was more suitable for the femoral intertrochanteric fracture in the elder.