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Objective To investigate the clinical efficacy and significance in the treatment of elderly patients with intertrochanteric fracture Gamma nail. Methods A retrospective analysis of the January 2006 to January 2008, our hospital intertrochanteric fractures in elderly patients with a total of 60 cases, aged 60-92 years old, with an average of 71.28 years old. Males and 31 cases (51.67%) and 29 females (48.33%). According to the AO classification :31-A1 type in 10 cases (6 males and 4 females) ,31-A2 type, 44 cases (23 male and 21 female patients) ,31-A3 type in 6 cases (3 males and 3 females cases), in all cases using the Gamma nail treatment, from admission to surgery time is 1-5 days (average 2.8 days). Follow-up of this group of patients (periodic review of X-ray), the observed functional recovery by Harris function score (pain, activity, walking ability, daily life and sit a total of five indicators) to assess fracture healing. The combined medical disorders (diabetes, cardiovascular and cerebrovascular diseases and respiratory diseases, etc.) accounted for 96.67% of the cases in this group. For patients with combined medical illness, preoperative comprehensive assessment of the patient's body to consider given active treatment using the Gamma nail treatment, are to be merged for Disease Control can not tolerate surgery. The results of 60 patients after the Gamma nail, are regular follow-up, follow-up time of 9 to 20 months, an average of 14 months. Complete follow-up data of 57 patients (60 cases, 1 died of a lung infection, and 1 patient died of myocardial infarction, patients lost to follow) in 49 cases healed well, four cases occurred coxa vara, two cases of infection ( given antibiotics, wound dressing), 2 cases of lag screw cutting piercing, all bone healing after symptomatic treatment. Reference to the Harris score hip score, excellent: 15 cases; benign: 37 cases; may: three cases; difference: two cases. The average score improved from preoperative 22.53 points to 93.29 points, the excellent and good rate was 91.23% (52/57), satisfactory functional recovery. Conclusions follow-up observation into the group of patients in this study, we experience: elderly patients with intertrochanteric fractures is often associated with a variety of medical disorders, poor physical condition, surgery tolerated poor surgical risk. Gamma nail with a small incision, less trauma, less bleeding, general surgery without blood transfusion, simple operation, fewer complications, and shorter operative time (25-70min, an average of 40min), etc.; short Gamma nail arm, bending moment is small, its biomechanical design more reasonable, shortened within fixed arm, reducing the role of the compressive stress of pulling nails, the treatment of various types of intertrochanteric fracture, while allowing the early postoperative period to carry out the hip rehabilitation training can shorten the course, reduce pain, improve the ability to take care of themselves. Not cut exposed fracture, without destroying the fracture blood supply, and will not affect fracture healing, Gamma nail in treatment, rated excellent rate of 91.23%. We believe that: the Gamma nail is a good method for the treatment of elderly intertrochanteric fractures, worthy of promotion.
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