| Objective:To compare the clinical results on the treatment of unstable intertrochanteric fracture with proximal femoral anatomic locking plate (ALP), percutaneous compression plate (PCCP), total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) in elderly patients.Methods:Data of 68 elderly patients, who had undergone surgical treatment of unstable intertrochanteric fracture with ALP, PCCP, THA and BHA from 2011 December to 2013 December in the department of orthopedics of the Second Affiliated Hospital of Chongqing Medical University, were retrospectively analyzed. There were 27 males and 41 females, aged from 67 to 98 years old (average 79.65 years old), included 12 cases in ALP group,12 cases in PCCP group,17 cases in THA group, 27 cases in BHA group. The operation duration, intraoperative blood loss, intraoperative X-ray perspective times, time to walking, and the Harris score at the last follow up of different groups were analyzed comparatively.Results:Operation duration:BHA< PCCP< THA< ALP. Intraoperative blood loss:PCCP< BHA< THA< ALP. Intraoperative X-ray perspective times:BHA= THA< PCCP< ALP. Time to walking:THA< BHA< PCCP< ALP. There were significant differences of all the statistics above among those groups (P<0.05) except the intraoperative blood loss between THA and BHA. There was no significant difference of statistics in the excellent rate of postoperative hip function among those groups (P>0.05).Conclusion:All the 4 procedures can achieve good clinical effect with their own characteristics on the treatment of unstable intertrochanteric fracture in elderly patients. BHA and PCCP have a smaller operative trauma. THA and BHA have advantages in intraoperative radiation dose and rehabilitation speed. |
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