| Background:In the 1970 s,a small number of doctors used artificial hip replacement to treat patients with intertrochanteric fractures in the elderly.At the beginning,artificial joint replacement was mainly used for initial treatment failure.For stable intertrochanteric fracture,internal fixation is still the main treatment,the effect is accurate.However,for the elderly with osteoporosis and unstable fracture,the fracture of the posterior medial bone cortex and the increased stress of internal fixation caused the femoral head or neck to be cut through the compression nail[1]、material fatigue fracture,fracture delay or malformation of the complication rate up to 7%[2].In addition,osteoporosis is often difficult to reach a solid state,and the incidence of hip pronation can be as high as half[3].With the improvement of surgical techniques and the improvement of artificial prostheses,gradually people have been selectively applied to some elderly patients and achieved satisfactory clinical results.At present,it is more and more acceptable to use artificial joint replacement to treat the intertrochanteric fracture of the femur.Objective: this study will be of elderly unstable fracture of the bone cement between rotor and biological clinical curative effect difference compared two kinds of fixed way,in order to elderly unstable femoral fractures of the hip joint replacement prosthesis choice between rotor to provide clinical basis.Methods: the retrospective study way,collect the second hospital joint surgery between January 2014 and January 2017,instability between rotor fracture in aged patients between 36 reports records.According to the intraoperative application of prosthesis type,there were 16 cases of bone cement type artificial semi-hip replacement group,including male 5,female 11,age 84-96,and average age 87.70 + 2.54.Evans-JensenⅡ type a type 6 cases,Ⅱ b type 6 cases,Ⅲ type 4 cases.6 cases of traffic injuries,10 cases were hurt.Body mass index BMI18.4-24.8 kg / ㎡.An average of 21.73 + /-1.47 kg / ㎡.There were 20 cases of biological artificial half hip replacement,including male 7,female 13,85-94 years old,with an average age of 87.60 plus or minus 2.74 years.According to Evans-Jensen parting Ⅱ type 7 cases,8 Ⅱ type b,type Ⅲ in 5cases.Traffic injuries 8 cases,12 cases fall.Body mass index BMI: 19.4-27.8 kg / ㎡,an average of 22.78 + /-2.21 kg / ㎡.The two groups of patients,hospital,surgery,postoperative and down time,intraoperative blood loss,postoperative flow,blood transfusion volume,postoperative complications,postoperative hip joint function score(Harris score)and its influence to learn information were analyzed.Results: biological and bone cement group of hip joint function score has no obvious difference(P > 0.05),two groups of postoperative Harris scores were higher than preoperative(P < 0.05),creatures and bone cement group operation time has no obvious difference(117.05 ± 10.22)vs(121.56 ± 9.79),postoperative of two groups have significant differences,bone cement is less than the biological group(242.00 ± 57.54)vs(166.25 ± 60.43).There was no significant difference in imaging data(P > 0.05).The postoperative hospitalization time of patients with bone cement group was longer than that of biological group,with significant difference(P < 0.05).Conclusion: it is a correct choice to have a good walking ability for the intertrochanteric fracture of the femur and the prosthesis of biological prosthesis and bone cement.In recent years,the rise of biological prosthesis,and the early postoperative period will also obtain a good immediate stability,and avoid the risk of bone cement poisoning.It is widely recognized,but long-term effects need to be followed up. |
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