Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures
Objective: To compare the clinical efficacy of proximal femoral intramedullary fixation and anatomical locking compression plate in the treatment of femoral intertrochanteric fractures among the elderly. Methods: In this retrospective study, 210 surgically treated patients with intertrochanteric fractures of the femur were analyzed and divided into groups A, B and C according to the surgical approach. Group A had interlocking compression nailing (INTERTAN) done (n=69); group B had γ-III
... B had γ-III interlocking intramedullary nailing (γ-III) done (n=73); and group C had proximal femoral anatomic locking plate (PFLP) done (n=68). All patients' data were followed up completely, and their clinical outcomes were observed. Results: Group A and B were found to perform better than group C in operation time, bleeding volume, time of leaving bed, fracture healing time and hospitalization time (P < 0.05). Their respective incidences of postoperative complications were significantly lower than that of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). The Harris scores of groups A and B at 1, 3 and 6 months after operation were significantly higher than those of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). Conclusions: In the treatment of femoral intertrochanteric fractures, intramedullary fixation influences little on blood circulation at the fracture end, accelerates fracture healing, and enhances hip joint function, which assists patients in recovering faster postoperatively. Moreover, it enables them to gain mobility at an early stage and reduces postoperative complications of fractures. Its short-term clinical effects are better than extramedullary fixation, which should be more widely adapted clinically.