Early Clinical Efficacy Comparison Study of Gamma3 Nail, Percutaneous Compression Plate (PCCP) and Femoral Head Replacement (FHR) Treatment on Senile Unstable Intertrochanteric Fractures.
OBJECTIVE
This study aimed to analyze the early clinical efficacy of Gamma 3 nail, percutaneous compression plate (PCCP) and femoral head replacement (FHR) treatments on senile unstable intertrochanteric fractures.


METHODS
Totally 116 patients were included to perform an retrospective study, which involved analysis of the operation time, intraoperative blood loss, and hemoglobin reduction on the first postoperative day compared with preoperative levels, fracture gap, neck shaft angle and tip apex distance on the first postoperative X-ray, hospital stay, time from surgery to mobilization, Harris hip scores and Barthel index six months after operation, and complications postoperative meanwhile were evaluated respectively among three groups.


RESULTS
The Harris hip score and Barthel index and time from surgery to mobilization after FHR treatment were superior to another two surgical methods, but had more blood loss and greater hemoglobin reduction. The mean PCCP hemoglobin reduction was notably shorter than that of the other two groups. Gamma 3 treatment had a lower operation time and blood loss than those treated with PCCP and FHR.


CONCLUSIONS
Gamma 3 and PCCP treatments are a priority for senile unstable intertrochanteric fractures if patients are in good health and perform fair activities of daily living prior to the operation, but had a significantly longer mobilization time than that in FHR. Therefore, considering the senile patients who unable to tolerate long immobilization time, FHR treatment is a considerable choice for faster recovery of independent function and achieve a good clinical efficacy as well as improve quality of life.
a Department of Orthopaedic Surgery , The First Affiliated Hospital of Soochow University , Suzhou 215006 , P.R. China.
Shaofeng
S
Yang
a Department of Orthopaedic Surgery , The First Affiliated Hospital of Soochow University , Suzhou 215006 , P.R. China.
Yanan
Y
Liu
a Department of Orthopaedic Surgery , The First Affiliated Hospital of Soochow University , Suzhou 215006 , P.R. China.
Tongqi
T
Yang
a Department of Orthopaedic Surgery , The First Affiliated Hospital of Soochow University , Suzhou 215006 , P.R. China.
Jun
J
Zou
a Department of Orthopaedic Surgery , The First Affiliated Hospital of Soochow University , Suzhou 215006 , P.R. China.
Huilin
H
Yang
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D058866:Osteoporotic Fractures / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
Gamma3 nail; clinical efficacy; fracture fixation; hemiarthroplasty; intertrochanteric fractures; percutaneous compression plate