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Objective: To investigate the dynamic hip screw (Dinamic Hip Serew, DHS) and proximal femoral nail (Proximal Femoral Nail, PFN) treatment of intertrochanteric fracture indications for its clinical efficacy. Materials and methods: (1) GENERAL INFORMATION: intertrochanteric fracture patients admitted to our hospital and the Second Clinical Hospital of Jilin University femur into PFN and DHS group the DHS group in the Second Clinical Hospital of Jilin University, acquisition cases, a total of 50 cases , including 25 males and 25 females, mean age was 60.3 years, Evans typing type Ⅰ 14 cases, 13 cases of type Ⅱ and type Ⅲ 13 cases 10 cases of type IV, V 0 cases, the type of injury in the plains fall injury 40 cases, 10 cases of traffic accident injuries, bone normal five cases, the decrease in bone mass in 20 cases, osteoporosis in 25 cases, with nine cases of pulmonary insufficiency and hypertension by 11 cases, heart disease 10 cases, diabetes in 11 cases, the nervous system disease for six cases, the merger of two or more of these diseases for 11 cases: the PFN group 81 cases, 37 males and 44 females, average age 58.5 years, Evans typing for 28 cases of type Ⅰ, Ⅱ 20 cases, 22 cases of type Ⅲ type IV, V - 3 cases, the type of injury, the plains and trauma 71 cases and traffic accident in 10 cases, the bone is normal for the five cases, reduced bone mass 38 cases of osteoporosis in 38 cases, with five cases of pulmonary insufficiency, hypertension by 26 cases of heart disease by 6 cases, diabetes by 18 cases of diseases of the nervous system of the four cases, merging two or more of these diseases by 19 cases. Results: All cases of the enrolled are -2.5-year follow-up of 6 months, with an average follow-up of 2 years. The two groups of patients were no complications in the process of internal fixation, after shooting the X ray examination, good fracture reduction and fixation. No patient internal fixation failure or due to infection, hip pain, dysfunction and other reasons need fixation remove. 1 year after filming fracture bone healing, femoral head necrosis and other complications, the patient can resume normal life before the injury. According to the evaluation standard, the 131 cases after internal fixation efficacy reached excellent DHS internal fixation surgery, mean operative time was 80.4 minutes, the average amount of bleeding 433.5ml, the average amount of blood transfusion in surgery 486.9ml, the average length of the incision 12.3cm, mean postoperative drainage volume 82.4ml: the PFN internal fixation group, the average operation time was 51 minutes, the average amount of bleeding 66.7ml surgery without blood transfusion, the average length of the incision 6.1cm, mean postoperative drainage volume was 45.8 ml, the PFN group operative time, blood loss, incision length and postoperative drainage flows are optimal in the two groups of patients, postoperative fixed loose and cutting two cases, contrast can be seen no significant difference (P> 0.05), hip varus The DHS group eight cases, the PFN group for the three cases, the difference was significant (P <0.05), this Description PFN surgical way causing coxa vara complications after surgery less than DHS group, and cause loosening complications both groups is the same. DHS group's excellent surgical rate was 80%, the PFN group's fine was 90%, the overall distribution of the two sets of test data nonparametric method, the difference was significant (P <0.05), this description of the PFN surgery in two excellent rate of the highest in the kinds of surgical procedures. 1 year after the Harris hip score can achieve good average 88.75 points, DHS group the PFN group average of 87.12 points, DHS group after an average healing time of 12.6 months, the PFN group were average healing time was 10.6 months: DHS group average the limb shortened to 1.6cm, the PFN group average limb shortened to 0.6cm, compared the two groups, the difference in the one year after hip score and the average healing time of fractures no statistically significant (P> 0.05), and shortened limbs complications on the difference was statistically significant (P <0.05). According to the age group, the number of bone mass, and fracture type grouping found similar surgery excellent rate of people of all ages, the age of each surgical approach: lower rate of postoperative patients with osteoporosis excellent lower than normal bone mass, while in the two surgical PFN more suitable for surgery osteoporosis; according to Evans classification found DHS excellent rate of type Ⅰ and Ⅱ fracture surgical PFN surgical Ⅲ, Ⅳ and Ⅴ fracture type excellent rate differences between each other no statistically significant (P> 0.05). Conclusion: 1.DHS and PFN internal fixation of intertrochanteric fractures can obtain satisfactory results, but smaller damage of the surgical procedure in PFN. Including 2.DHS and PFN fixation achieved bone healing around excellent hip score reached, but PFN postoperative recovery better hip function, especially for osteoporosis and type Ⅲ, Ⅳ type , and V fractures type even more so.
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