| Objective To evaluate the clinical effect of a self-made trochanter for reduction and fixation of displaced bone fragments involving the posterior medial lesser trochanter or the posterior lateral greater trochanter.Methods A prospective randomized study was carried out from January 2018 to October 2019 involving 30 elderly patients with intertrochanteric fractures (Futamura for posterior medial lesser trochanter and posterior lateral greater trochanter in type A3 fractures) who underwent minimally invasive surgery using the PFNA. Using random envelope grouping method, one group treated with displaced fragments by self-developed intertrochanteric reduction device reducing and fixing it, while another group was ignored. Evaluation variables, including operation time, intraoperative blood loss, weight bearing time, postoperative complications, incidence of postoperative adverse reactions, and final clinical outcomes by the end of follow-up were used to compare the benefits of these two therapeutic methods.Results The mean followed-up time was (14.1±2.3) months. The mean operation time was prolonged, and intraoperative blood loss was more when the displaced trochanter reducted and fixed by self-developed intertrochanteric reduction device. There was a statistical significance between the mean operation time and the intraoperative blood loss (P<0.05). The weight bearing time in the experimental group was earlier than that in the control group, there was a statistical significance between the two groups (P<0.05). The mean Harris score and FRS score in the experimental group were better than those in the control group at 1 month after operation, with statistical significance (P<0.05), while at 3 months, 1 year after operation, and there was no statistical significance between the two groups (P>0.05). There were no wound infection, cut-out of head, periprosthetic fractures, thrombosis of deep veins of lower limbs between the two groups. Postoperative adverse reactions (poor diet, constipation, postoperative fever) in the experimental group were equivalent to those in the control group, with no statistical significance (P>0.05).Conclusion The self-developed intertrochanteric reduction device aid in early mobilization and early return of ambulatory function with more surgical time and blood loss. However, for the elderly with severe complications, in order to shorten the operation time, reduction and fixation of displaced trochanter is not recommended. |
