EFFECTIVENES OF ANTEROLATERAL C-SHAPED APPROACH IN TREATMENT OF INTERTROCHANTERIC FRACTURE OF FEMUR IN ELDERLY PATIENT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Binghua ¹ , DAI Min ² , ZOU Fan ² , ZHANG Bin ² , LI Binhua ² , LUO Song ² , QIU Ping ²

1Department of Orthopedics, the Fourth Affilliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China;;
2Department of Orthopedics, the First Affilliated Hospital of Nanchang University. Corresponding author: DAI Min, E-mail: daimin@medmail.com.cn;

Corresponding author：

Keywords：

Anterolateral C-shaped approach; Intertrochanteric fracture of femur; Dynamic hip screw; Elderly patient

DOI：

10.7507/1002-1892.20130214

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Objective To study the effectiveness of anterolateral C-shaped approach in the treatment of intertrochanteric fracture of the femur in elderly patient by comparing with traditional anterolateral approach. Methods Between April 2010 and November 2011, 66 patients with intertrochanteric fracture of the femur were analyzed retrospectively. Of 66 patients, 37 underwent improved anterolateral C-shaped approach combined with fixation of dynamic hip screw (DHS) (improved group), and 29 underwent traditional anterolateral approach combined with fixation of DHS (conventional group). There was no significant difference in gender, age, injury cause, side, disease duration, fracture type, and complication between 2 groups (P gt; 0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospitalization time were recorded; and X-ray films were taken to observe the fracture healing. The hip function was evaluated according to self-established criterion. Results The operation was successfully completed in all patients, and primary healing of incision was achieved. All patients were followed up 12-24 months (mean, 17.8 months). Bone union was achieved in both groups; the fracture healing time was 3-6 months (mean, 4.8 months). No loosening or breaking of internal fixation was observed during follow-up period. The operation time and postoperative drainage volume of improved group were significantly less than those of conventional group (P lt; 0.05); no significant difference was found in intraoperative blood loss and hospitalization days between 2 groups (P gt; 0.05). According to self-established criterion, improved group was significantly better than conventional group in recovery of hip joint motion and function at 6 and 12 months after operation (P lt; 0.05). Conclusion Anterolateral C-shaped approach combined with DHS could minimize muscle injury and scar formation, which is beneficial to surgical exposure and early postoperative rehabilitation.

Citation： WU Binghua,DAI Min,ZOU Fan,ZHANG Bin,LI Binhua,LUO Song,QIU Ping. EFFECTIVENES OF ANTEROLATERAL C-SHAPED APPROACH IN TREATMENT OF INTERTROCHANTERIC FRACTURE OF FEMUR IN ELDERLY PATIENT. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(8): 985-989. doi: 10.7507/1002-1892.20130214 Copy

1.	高斌. 老年股骨粗隆间骨折不同内固定治疗疗效观察. 四川医学, 2012, 33(1): 80-82.
2.	Evans EM. The treatment of trochanteric fractures of the femur. J Bone Joint Surg (Br), 1949, 31B(2): 190-203.
3.	戴闽, 艾江波, 范红先, 等. 早期系统康复对老年股骨近端骨折的影响. 南昌大学学报: 医学版, 2010, 50(3): 46-48.
4.	张斌, 戴闽, 唐亚敏, 等. 骨折治疗与运动康复一体化对股骨粗隆间骨折术后疗效的影响. 中国修复重建外科杂志, 2012, 26(12): 1453-1456.
5.	Soohoo NF, Farng E, Chambers L, et al. Comparison ofcomplication rates between hemiarthroplasty and total hiparthroplasty for intracapsular hip fractures. Orthopedics, 2013, 36(4): e384-389.
6.	赖苑威, 张根民. 股骨粗隆间骨折内固定并发症原因分析. 中国修复重建外科杂志, 2009, 23(1): 120-122.
7.	Jain RJ, Basinski A, Kreder HJ. Nonoperative treatment of hip fractures. Int Orthop, 2003, 27(1): 11-17.
8.	Kois DE, Isvilanonda V, Chaiyabutr Y, et al. Evaluation offracture resistance and failure risks of posterior partial coverage restorations. J Esthet Restor Dent, 2013, 25(2): 110-122.
9.	Encinas-Ullán CA, Fernandez-Fernandez R, Rubio-Suárez JC, et al. Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures. Rev Esp Cir Ortop Traumatol, 2013, 57(2): 117-122.
10.	Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat, 1989, 166: 179-189.
11.	Zhang XL, Shen H, Qin XL, et al. Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study. Chin Med J (Engl), 2008, 121(15): 1358-1363.
12.	王仁, 张春才, 侯铁胜, 等. DHS内固定治疗老年股骨粗隆间骨折. 中华创伤骨科杂志, 2001, 3(1): 27-28.
13.	Aros B, Tosteson AN, Gottieb DJ, et al. Is a sliding hip screw or im nail the preferred implant for intertrochanteric fracture fixation? Clin Orthop Relat Res, 2008, 466(11): 2827-2832.
14.	邹帆, 戴闽. 早期运动康复对下肢骨折治疗的临床意义. 中国矫形外科杂志, 2011, 19(24): 2065-2068.
15.	Butcher JL, MacKenzie EJ, Cushing B, et al. Long-term outcomes after lower extremity trauma. J Trauma, 1996, 41(1): 4-9.
16.	陈晟, 戴闽, 帅浪, 等. 影响肱骨远端骨折治疗效果的多因素回归分析. 中国矫形外科杂志, 2009, 17(8): 633-635.
17.	戴闽. 实用骨科治疗与康复. 北京: 人民卫生出版社, 2007: 206-210.

1. 高斌. 老年股骨粗隆间骨折不同内固定治疗疗效观察. 四川医学, 2012, 33(1): 80-82.
2. Evans EM. The treatment of trochanteric fractures of the femur. J Bone Joint Surg (Br), 1949, 31B(2): 190-203.
3. 戴闽, 艾江波, 范红先, 等. 早期系统康复对老年股骨近端骨折的影响. 南昌大学学报: 医学版, 2010, 50(3): 46-48.
4. 张斌, 戴闽, 唐亚敏, 等. 骨折治疗与运动康复一体化对股骨粗隆间骨折术后疗效的影响. 中国修复重建外科杂志, 2012, 26(12): 1453-1456.
5. Soohoo NF, Farng E, Chambers L, et al. Comparison ofcomplication rates between hemiarthroplasty and total hiparthroplasty for intracapsular hip fractures. Orthopedics, 2013, 36(4): e384-389.
6. 赖苑威, 张根民. 股骨粗隆间骨折内固定并发症原因分析. 中国修复重建外科杂志, 2009, 23(1): 120-122.
7. Jain RJ, Basinski A, Kreder HJ. Nonoperative treatment of hip fractures. Int Orthop, 2003, 27(1): 11-17.
8. Kois DE, Isvilanonda V, Chaiyabutr Y, et al. Evaluation offracture resistance and failure risks of posterior partial coverage restorations. J Esthet Restor Dent, 2013, 25(2): 110-122.
9. Encinas-Ullán CA, Fernandez-Fernandez R, Rubio-Suárez JC, et al. Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures. Rev Esp Cir Ortop Traumatol, 2013, 57(2): 117-122.
10. Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat, 1989, 166: 179-189.
11. Zhang XL, Shen H, Qin XL, et al. Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study. Chin Med J (Engl), 2008, 121(15): 1358-1363.
12. 王仁, 张春才, 侯铁胜, 等. DHS内固定治疗老年股骨粗隆间骨折. 中华创伤骨科杂志, 2001, 3(1): 27-28.
13. Aros B, Tosteson AN, Gottieb DJ, et al. Is a sliding hip screw or im nail the preferred implant for intertrochanteric fracture fixation? Clin Orthop Relat Res, 2008, 466(11): 2827-2832.
14. 邹帆, 戴闽. 早期运动康复对下肢骨折治疗的临床意义. 中国矫形外科杂志, 2011, 19(24): 2065-2068.
15. Butcher JL, MacKenzie EJ, Cushing B, et al. Long-term outcomes after lower extremity trauma. J Trauma, 1996, 41(1): 4-9.
16. 陈晟, 戴闽, 帅浪, 等. 影响肱骨远端骨折治疗效果的多因素回归分析. 中国矫形外科杂志, 2009, 17(8): 633-635.
17. 戴闽. 实用骨科治疗与康复. 北京: 人民卫生出版社, 2007: 206-210.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENES OF ANTEROLATERAL C-SHAPED APPROACH IN TREATMENT OF INTERTROCHANTERIC FRACTURE OF FEMUR IN ELDERLY PATIENT

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