Clinical Research Of Hip Atrhroplasty And Two Kinds Of Internal Fixation For Intertrochanteric Fracture In Senior Citizens

With the aging of the population, the incidence of osteoporosis is increasing. Theincidence of elderly intertrochanteric fracture is increasing, the reason is that Osteoporosislead to reduced bone strength. Its rational treatment, especially for citizens with unstableintertrochanteric fractures, Which has a meaning in improving patient’s quality of life andliving skills.Objective: To compare the clinical efficacy between hip arthroplasty and internalfixation for intertrochanteric fracture in senior citizens;exploring hip arthroplasty is thetreatment of elderly unstable intertrochanteric fracture in indications, complications aswell as preoperative and postoperative precautions and handling methods.Methods: The Second Clinical Hospital of Jilin University from October2009toOctober2011the treatment of intertrochanteric fracture in56cases, including24malesand32females; age70to87years, mean75.6years. Causes of injury:49cases of theirown fall, car accident injured six cases, and one cases of injured patients were closedfractures, and with varying degrees of osteoporosis. Fractures by Evans classification areunstable in22cases, IIIA, IIIB(20),IV(14). Injury to the operation time of2-18days, anaverage of seven days. According to the contralateral hip anteroposterior X-ray filmaccording to Singh grading. Proximal femur mechanical strength in three of28cases.Coexistence of internal diseases in17patients, in which the coexistence of an eight cases,the coexistence of two kinds of five cases, the coexistence of three kinds of four cases.Hypertension, coronary heart disease, diabetes, chronic bronchitis, cerebral thrombosis,The patients were followed up for2months to3years, with an average of15months. Thetreatment is divided into: the dynamic hip screw in the treatment group of22cases ofproximal femoral nail16cases,18cases of hip arthroplasty group.Recorded within the fixed group and the arthroplasty group intraoperative blood loss,operative time; time in bed after surgery, postoperative complications, excellent rate;postoperative hip, knee Harris score, and statistical software SPSS13.0statisticalanalysis.Results: The operation time of hip arthroplasty and internal fixation has nosignificantdifference (p>0.05); replacement group spends less time than the fixation group out of bed (P <0.01); replacement group compare with fixed group in amount of blood loss (p>0.05); and the incidence of postoperative complications (p>0.05) has no significantdifference, but the replacement group is not occurred in the bed brake relatedcomplications within a fixed group out of bed braking time longer, more complications;excellent rate statistics, the replacement group with a fixed group treatment of the formergood rate slightly higher than the latter, the quick recovery of function after replacementgroup, There is no significant difference(p>0.05).Conclusion: The artificial joint replacement surgery as the elderly osteoporoticunstable femoral intertrochanteric fracture of one of the options, but the indications forsurgery should be strictly controlled, the surgery should take the appropriate treatmentaccording to its characteristics, active prevention of perioperative diagnosis and treatmentof underlying diseases, and reduce the incidence of complications.Slightly less in this group the number of cases, there are some limitations to reflectthe accuracy of the results. Under this set of results, combined with the superiority of thebipolar artificial femoral head replacement, in theory, large-scale replacement group andinternal fixation group, randomized controlled study was made possible.