Comparison Of Hip Arthroplasty And Internal Fixation For The Treatment Of Unstable Osteoporotic Intertrochanteric Fractures In Elderly Patients

Objective:To observe the clinical effect of the hip arthroplasty treating theunstable Osteoporotic intertrochanteric fractures in the eldly and toapproach the clinical significance. Documents and Methods:32 advanced age patients (17 men and 15 women) suffered by theunstable Osteoporotic intertrochanteric fractures in the eldly wereselected from January 2004 to February 2006 in the First Hospital ofJinlin Universicity. The patients' ages were all older than 60 andbelonged to the unstable types according to Evans-Jensenclassification. While 11 patients in the hip arthroplasty group, Theages were between 62 to 90 and the average age was 75.1. Theflow-up visit was between 5 months to 28 months, and the averagetime of flow-up visit was 17.1 months. While the 21 advanced agepatients suffered by the unstable intertrochanteric fractures in the eldlyin the internal fixation group. The ages were between 60 to 93 and theaverage age was 75.1. The flup time was between 3 months to 28months, and the average time of flow-up visit was 14.3 months. Recorded the time and blood-transfusion during operation in bothgroups, and fluped the ambulatory time, the occurrence ofcomplications and the FRS scores and Harris scores before operationand after operation, and compared the scores decrease after operation.Result:There was no difference in operation time between the hiparthroplasty group and the internal fixation group (P>0.05). The timeto ambulation in the hip arthroplasty group was shorter than that of theinternal fixation group (P<0.01). The blood-transfusion duringoperation was compared in the two groups by Rank sum test and itshowed that there was no difference in the volume ofblood-transfusion between the hip arthroplasty group and the internalfixation group (P>0.05). There was no significant difference inpostoperative complications incidence rate between the two groups,but there were no complications related to lying in bed and caging inthe hip arthroplasty group, while there were many postoperativecomplications in the internal fixation group because of the long timelying in bed. The decrease of FRS scores and Harris scores afteroperation was compared in the two groups by t-test and It showed thatthe curative effect of the hip arthroplasty group was better than theinternal fixation group (P<0.05).Conclusion: The hip arthroplasty can be one of the therapies tothe unstable Osteoporotic intertrochanteric fractures in the eldly, butthe operation indication should be chosen strictly and the propotionaltreatments should be taken during operation according to itscharacteristic and positive prophylaxis should be taken to reduce theoccurrence of complications.Because the cases of particular disease were few, it was limitedto some extent to reflect the result accurately and overall. Accordingto the result of the investigation and the abstract superiority of theprosthetic replacement, I t is possible to perform the freely controlstudy in large scale between in the prosthetic replacement group andthe internal fixation group.