Application Of Two-step Osteotomy In Hemiarthroplasty For Unstable Intertrochanteric Fractures In Elderly Patients

Objective:To introduce bipolar hemiarthroplasty with a two-step osteotomy technique and observe its clinical result for unstable intertrochanteric frac-tures in senile patients.Methods:A retrospective analysis was made of 42 patients who underwent hemiarthroplasty from August 2015 to December 2019 due to unstable intertrochanteric fractures.The consecutive patients with unstable intertrochanteric fractures aged from 66 to 90 years with a mean of 75 years were treated in our hospital(Evanstype III in 25 cases,Evans type IV in17cases),Finally,42 patients were included in the statistics.Biological hemihip arthroplasty was performed by a senior orthopaedic surgeon through a posterior approach.The control group was treated with two-step osteotomy,while the experimental group was treated with traditional osteotomy.The operative time,intraoperative and postoperative blood loss,hospital stay,postoperative Harris score of hip joint and complications of the two groups were observed and recorded.All patients were followed up for 1 year.Results:The amount of intraoperative blood loss,duration of operation and length of hospital stay in the study group were shorter than those in the control group(P < 0.05).There was no significant difference in the incidence of complications between the two groups(P > 0.05).The excellent and good rate of hip joint function in the study group was higher than that in the reference group(P < 0.05).Conclusion:Hemiarthroplasty with a two-step osteotomy technique for unstable intertrochanteric fractures in the senile patients is a good choice,compared with the traditional osteotomy method,it can shorten the operation time,reduce the surgical trauma,much less hemorrhage than previous method can occur,and quickly restore the function of the proximal femur.