Extramedullary fixation with dynamic hip screw versus internal fixation with proximal femoral nail in treatment of intertrochanteric fracture

Objective To analyze the clinical effects of extramedullary fixation with dynamic hip screw and internal fixation with proximal femoral nail in the treatment of intertrochanteric fracture. Methods Ninety patients confirmed with intertrochanteric fracture treated at our hospital from February, 2014 to February, 2016 were divided into an extramedullary group (n=45) and an intramedullary group (n=45) according to the admission order. The extramedullary group were treated with extramedullary fixation with dynamic hip screw and the intramedullary group internal fixation with proximal femoral nail. The state of operation in both groups was observed and recorded to evaluate the effect of postoperative recovery. The indicators included operation time, intraoperative bleeding volume, incision healing time, fracture healing time, and time of walking. 6 months after operation, the Harris score was used to evaluate the operation effects in the two groups. Results The wound healing time was slightly shorter in the intramedullary group than in the extramedullary group (P > 0.05). The operative time, time of walking, and fracture healing time were significantly shorter and the intraoperative bleeding volume was significantly lower in the intramedullary group [(67.47±11.18) min, (6.32±1.09) weeks, and (8.93±2.12) weeks and (153.95±16.74) ml]than in the extramedullary group than that of extramedullary group (P < 0.05). 6 months after operation, the excellent and good rate of operation effects was significantly higher in the intramedullary group than in the extramedullary group (91.11% vs. 77.78%, P<0.05). Conclusion Internal fixation with proximal femoral nail in treatment of intertrochanteric fracture has better clinical effect and recovery than extramedullary fixation with dynamic hip screw. Key words: Extramedullary fixation with dynamic hip screw; Internal fixation with proximal femoral nail; Intertrochanteric fracture