title: [Effectiveness comparison of improved anterolateral approach and lateral approach in treatment of senile intertrochanteric fracture].
abstract: OBJECTIVE
  To compare the effectiveness between improved anterolateral approach and lateral approach in the treatment of senile intertrochanteric fracture.
  
  
  METHODS
  The clinical data were retrospectively analyzed, from 61 patients with senile intertrochanteric fracture treated between February 2008 and February 2010. Of 61 patients, 34 patients underwent improved anterolateral approach combined with fixation of dynamic hip screw (improved group), and 27 patients underwent conventional lateral approach combined with fixation of dynamic hip screw (conventional group). There was no significant difference in gender, age, injury cause, Evans classification, comorbidities, disease duration, or Harris hip scores between 2 groups (P > 0.05).
  
  
  RESULTS
  The operation was successfully completed in all patients. The operation time, blood loss, perspective frequency during operation, drainage volume, hospitalization days, and out-of-bed time in the improved group were significantly less than those in the conventional group (P < 0.05). All patients were followed up 12-24 months (mean, 18.7 months). Bone union was achieved in both groups; the fracture healing time was (11.64 +/- 1.28) weeks in the improved group and was (12.29 +/- 1.12) weeks in the conventional group, showing no significant difference (t = 2.15, P = 0.15). Harris hip scores at 3, 6, and 12 months were significantly better than preoperative scores in 2 groups (P < 0.05), and significant differences were found among different time points after operation in 2 groups (P < 0.05), between 2 groups after operation (P < 0.05). There was no significant difference in the incidence of incision infection, limb shortening, coax vara, internal fixation loosening, main screw cutting-out from femoral head between 2 groups (P > 0.05), but the incidence of total complications in the improved group was significantly lower than that in the conventional group (P < 0.05).
  
  
  CONCLUSIONS
  Compared with conventional lateral approach, improved anterolateral approach has the advantages of sufficient exposure, reducing muscle damage and surgical risk in treating intertrochanteric fracture. Operating treatment of improved anterolateral approach combined with early rehabilitation after surgery can recover hip joint function as quickly as possible.
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Nanchang University, Nanchang Jiangxi 330006, PR China. 413097263@qq.com
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.forename: Fan
authors.initials: F
authors.lastname: Zou
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Tao
authors.initials: T
authors.lastname: Nie
authors.forename: Ming
authors.initials: M
authors.lastname: Cheng
authors.forename: Yang
authors.initials: Y
authors.lastname: Zou
authors.forename: Chuan
authors.initials: C
authors.lastname: Jiang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005270:Femur Head / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome