[Improved minimally invasive DHS internal fixation for old age patients with intertrochanteric fractures]

To discuss the improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged and the influence on the lateral wall of the femoral.

From January 2005 to December 2010,480 aged patients with intertrochanteric fractures were treated by modified minimally invasive DHS fixation. There were 21 males and 268 females,with an average age of 78.3 years old ranging from 60 to 103 years. Aaccording to the Evans type,there were 166 cases of type 1,212 of type II , 86 of type 111, 16 of type IV, among them 46 cases had the dangerous fractures of the lateral wall. The incision length,blood loss volume,time from extending surgical incision in the side panel to close and postoperative complications were observed and recorded. At 1 month, 3 and 6 months after operation,the patients were followed-up,the outcome were evaluated according to the imaging evaluation index and clinical effect assessment indexes.

The surgical incision length averaged (8.0+/-1.2) cm, peri-operative bleeding averaged (150.0+/-6.4) ml,time from extending the incision in the operation to close incision averaged (22.0+/-1.3) min, 1 case had postoperative rupture of the external wall, and 3 cases had tension screw cut out in the femoral head,4 cases had excessive shrink back. Postoperative 6 months basic daily living skills (BADL) averaged (14.8+/-1.1) scores, and the ability of walk averaged (6.40+/-0.34) scores.

Improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged had advantages of small trauma surgery,short wound exposure time, less peri-operative bleeding and the integrity of the lateral wall after operation, the basic daily living skills and ability to walk has an ideal recovery activities, satisfied clinical curative effect.