A comparison of navigational and traditional dynamic hip screw fixations for intertrochanteric fractures in elderly patients

Abstract

Objective To compare the navigational and traditional dynamic hip screw （DHS） fixations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our department from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 cases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 females, with an average age of 82.8 years. They were 16 cases of Evans type Ⅰand 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 （average, 14） months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 （average, 18） months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences （ P 〈 0.05）. The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups （ P 〉 0. 05） . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups （ P 〉 0.05）. Conclusion In the treatment of intertrochanterie fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its advantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and better functional recovery. Key words: Hip fracture; Dynamic hip screw; Surgery, computer-assisted; Aged