Clinical Evaluation Of Treatment Of Comminuted Intertrochanteric Femoral Fracture In The Elderly With Hip Hemiarthroplasty

Objectives:To study and evaluate results of prosthetic replacement for the management of unstable intertrochanteric fractures in the elderly.Methods:A retrospective analysis of 21 consecutive the elderly cases of prosthetic replacement for unstable intertrochanteric fractures was conducted.Five of 21 cases were male and sixteen cases were female. Twenty one cases had an average age of 78.7 years (ranged 71～102 years) . TypeⅢof the fracture by Evans classification was in 5 cases ,Ⅳin 10 cases ,Ⅴin 6 cases .All were fresh communited frature. Epidural anesthesia were performed during the operation。Special attention should be paid to the preservation of larger peri-trochanteric fragments during the operation and the fragments should be fixed with steelwires. Bone defects were stuffed with bone cement.Results:All operations were successful. 21 patiens were followed up ; Followed - up period ranged from 3 months to 26 months (average 16 months). None shock or died in operation. The mean time from hospital admission to surgery was5 days(1～7days). The mean operation time was 91 minutes (65～155 minutes). During the operation blood transfusion was 400～1300m(laverage 600ml). The time of getting after operation were 4～27days(average 11.8 days).The period of hospitalizations was between 10 to 27 days with an average of 19.3 days. There were not complications of deep infection,dislocation,loose and urinary infection. Venous thrombosis in one case and one lung infection in one case were found.Conclusion:Prosthetic replacement for the management of unstable intertrochanteric fractures in the elderly is desirable. Satisfactory results can be obtained when the indication controlled stricklly.