[Clinical efficacy of fixation bone fragments by screw though cortical bone tunnel combined with limited open reduction in treating 31A3 type irreducible femoral intertrochanteric fractures in elderly people].

Objective

To explore and analyze the clinical efficacy of fixation bone fragments by screw though cortical bone tunnel combined with limited open reductionin treating 31A3 type irreducible femoral intertrochanteric fractures in elderly people.

Methods

Clinical data of 18 elderly patients with 31A3 type irreducible femoral intertrochanteric fractures treated from July 2017 to June 2018 in Orthopedics Department of Jiangsu Province Hospital were collected and analyzed retrospectively. There were 8 males and 10 females, aged from 65 to 88 years (mean age,(76±4) years). When confirmed as irreducible femoral intertrochanteric fractures by C-arm machine during operation, limited open reduction and fixation bone fragments by screw though cortical bone tunnel and intramedullary nail fixation were conducted. General surgical data,the quality of fracture reduction and functional recovery scale (FRS) score were collected.Data before and after operation were compared with paired t-test.

Results

All patients were followed up for a mean of 13.6 months (10 to 22 months). The surgical time was (55±13) min (42 to 95 min), the intraoperative blood loss was (223±26) ml (180 to 320 ml), the number of intraoperative fluoroscopy was 23±4 (18-32 times), and the fracture healing time was (4.8±0.7) months. The quality of fracture reduction was rated as grade Ⅰ in 15 cases andgrade Ⅱ in 3 cases, with an excellent to good rate of 100% according to Kim classification. FRS score was 84±10 at the last follow-up and it was comparable with that before injury (84±11) (t=0.144, P=0.887).

Conclusion

For elderly patients with 31A3 type irreducible femoral intertrochanteric fractures, fixation bone fragments by screw though cortical bone tunnel combined with limited open reduction is an efficient treating method with advantages of high quality of fracture reduction and fixation without increasing of surgical time and blood loss.