The Choice Of The Treatments Of Geriatric Femoral Interchanteric Fractures (61 Cases)

Objective:To investigate the choice of the trements of the geriatric femoral interchanteric fractures through 61 cases treated in our hospital,and give some advice to the clinical practice.Method:61 qualified geriatric femoral interchanteric fracture cases were enrolled in this study from March 2006 to February 2009 treated in out hospital.There are 20 men with a mean age of 75.2 years (ranging from 65 to 92 years) and 41 women with a mean age of 76.2 years(ranging from 62 to 92 years),including 29 left cases and 32 right cases.The fructures were classified by Evans standard,5 cases belong to typeⅠand typeⅡ,which were accepted conservative therapy, others including:typeⅢA 18 cases,typeⅢB 13 cases,typeⅣ20 cases and typeⅤ5 cases,these cases were received operations,including 31 arthroplasty(1 case of total joint arthroplasty,30 cases of hemiarthroplasty),using the prosthesis with bone cement and 25 patients undergone DHS(dynamic hip screw).After the follow-up ranges from 5 to 30 months(mean 17.5 months).Were collect the imformations of the operation time,the transfusion quantity in or after the operation,the time on the bed after operation,the function of the hip joint and the complication of all the patients in this study.The statistic results are come from the SPSS 13.0 statistic software.Results:1 patient died in the conservative group,1 died in the DHS group and 2 died in the arthroplasty group respectively.The operation time between the two groups has statistic meaning(p=0.002＜0.05),the time on the bed of the arthroplasty group is shorter than the DHS group, the transfusion quantity of the DHS group has no correlations with the arthroplasty group,the complation of the two groups has no statistic meaning,but there is more complication related to bed in the DHS group,under the Harris hip joint score system,the score of the arthroplasty group is higher than the DHS group(p＜0.05).Conclusions:1.Although there are too few samples in this study,the mortality of the conservative therapy of geriatric femoral interchanteric fractures is as high as some related reports;2.When it comes to the geriatric femoral interchanteric fractures, the arthroplasty is much better than DHS in many aspects,such as the operation time,the time on the bed and the hip joint function,but there is no fifference between the two group in the transfusion quantity;3.Arthroplasty is valuable for the old patients with femoral interchanteric fractures,it shorts the operation time and the time on the bed,so it can decrease the complication and mortality;...