Effect of intramedullary fixation under the manual tranction reduction in the treatment of femoral intertrochanteric fractures in 35 case

Objective:To explore the operation methods and clinical effects of intramedullary fixation under the manual tranction reduction in the treatment of femoral intertrochanteric fractures.Methods:The clinical data of 35 patients with femoral intertrochanteric fractures were retrospectively analyzed.All patients were treated with intramedullary fixation under the manual tranction reduction,the intraoperative blood loss was observed.The fracture healing and myositis ossificans occurrence were detected by radiograpy at postoperative l,3,6 months and 1 year.The hip joint function recovery of patient was evaluated using Harris scoring system.Results:Among 35 patients,30 cases were followed up for 1 to 59 months.30 cases were treated with PFNA,1 case was treated with PFNA combined with femoral neck pressure hollow screw nails and 4 cases were treated with intertan nails.Closed reduction in 31 cases and open reduction in 4 cases were implemented.According to the Harris score,16 cases were excellent,10 cases were good,3 cases were fair and 1 case was bad,the excellent and good rate of which was 86.7%.One case was accompanied with femoral medial cortical bone fracture during operation.One case was lacunar cerebral infarction at postoperative 2 days,and it recovered after symptomatic treatment.Among 30 cases with following-up,there was not infection and internal fixation failure,and all the fractures healed.The distal fractures of internal fixation in 1 case was caused by car accident.Conclusions:Intramedullary fixation is an effective method for treating the femoral intertrochanteric fractures.Unarmed manual traction reset can also achieve the ideal treatment effect,but the operation skills should be paid more attention to.