| Objective:Comparison of artificial hip joint replacement and LCP fixation treatment ofunstable intertrochanteric fractures Operative time, blood loss, postoperative time inbed, the incidence of postoperative complications, fracture healing time,≧75-year-old joint replacement and internal fixation of postoperative complications andjoint function and bone Singh,≦III level arthroplasty and internal fixation ofpostoperative complications and joint function; Explore two methods of treatment ofunstable intertrochanteric fracture efficacy.Materials and Methods:This test is retrospective study of the Jilin University Bethune Second ClinicalHospital from January2009to January2012treatment of elderly intertrochantericfracture in47cases, Including20males and27females; age65-92years, mean78.5years. Modified Evans classification,16cases of type Ⅱ a, Ⅱ b,19cases,12cases oftype III; the left side of27cases of fracture of the right of fractures in20cases,bilateral fracture patients. All subjects are fresh, closed fractures, no merger ofimportant neural and vascular injury; preoperative time of injury1h~3d. Damageipsilateral hip pain, normal activities. Treatment is divided into: Arthroplasty group(group A)25cases, the locking plate fixation group (Group B)22cases.Patients hadobvious fractures loose change, combined cardiovascular and cerebrovascular diseasein22cases,15cases of diabetes.The statistical analysis the SPSS19.0packagesrelated analysis and data processing on the data collected and indicators. Results: thefollow-up of all47cases were followed for an average of6months (3to12months).LCP fixation group and joint replacement surgery time compared accordingto P values>0.05was no significant difference, P value <0.05surgical bleedingsignificantly different. Both groups incidence of postoperative complications x2test data rows, P <0.05, fixed with joint replacement postoperative complication rate wasno significant difference. Two sets of time in bed, fracture healing time and6monthsafter the joint function of the comparison data t-test, P <0.05Description jointreplacement and LCP after bed time and postoperative joint function weresignificantly different. P>0.05no significant difference in postoperative fracturehealing time for joint replacement and LCP. Two sets of≧75-year-old jointreplacement and internal fixation of postoperative complications and joint function,the data t-test, P values>0.05prompted≧75-year-old joint replacement and internalfixation of postoperative complications and joint function were significantlydifferences. Bone Singh,≦III level arthroplasty and internal fixation of postoperativecomplications and joint function, the complication rate of data rows x2test, jointscore data t-test. P>0.05prompt bone Singh,≦III level arthroplasty and internalfixation of postoperative complications and joint function were significant difference.Conclusion:in elderly patients with serious complications and can tolerate surgery should bepreferred to open reduction and internal fixation.Both of two methods of surgicalindications for elderly patients with unstable intertrochanteric fractures is. LCP fixedstability. But extramedullary fixation system, the arm length, unstableintertrochanteric fracture, due to the destruction of the femoral calcar, long-term fixedcan withstand the tremendous tensile stress of the lateral femoral cortex, severeosteoporosis, age≧75years oldof patients likely to cause the failure of internalfixation. Artificial joint replacement in the treatment of elderly patients with unstableintertrochanteric fractures is safe and effective. More suitable for severe osteoporosis,age≧75-year-old patients. The incidence of postoperative complications, bone andjoint function recovery and good long-term efficacy. For elderly patients over the ageof75to avoid implants removed, and no secondary surgical treatment. Patients shouldbe actively to the prevention of postoperative complications and patient age, fracturetype and bone exercise is very important to guide the hip. |
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