Artificial Hip Replacement In The Treatment Of Elderly Femoral Intertrochanteric Fractures

Objective:Further discuss the risk and effect of curing Femoral Intertrochanteric fractures in the oldest old by artificial hip replacement in order to provide a reference for a more efficient way in the clinical treatment.Method:The study used the retrospective analysis. Since January2008to October2010, the department divided the oldest old Femoral Intertrochanteric fracture patients into groups. The Evans-Jensen typing was chosen in the Femoral Intertrochanteric Fracture. Totally72patients were chosen,50patients in Artificial hip replacement Group, including13males,37females, aged from75to95, the average age was81.9. The experimental group accepted artificial hip replacement operation, including34patients using the lengthen-stem cemented total hip arthroplasty(THA),6using the standard-stem cemented THA and10using bipolar lengthen-stem cemented THA. Totally22patients in internal fixation Group, including10females,12males, aged from75to88, the average age was78.91. The internal fixation Group accepted the open reduction and internal fixation operation, including11using dynamic hip screw internal fixation,3using proximal femoral nail internal fixation and8using locking plate internal fixation. A comparative study was made on the clinical index of age, hospital stays, operation time, blood loss during operation, time of first mobilization, complications, the Harris evaluation and excellent rate of hip joint function by looking up medical records, reviewing and follow-up cares.Result:①There was no obvious difference in hospital stays and operation time between Artificial replacement of hip joint Group and internal fixation Group, there was no statistical significance (P>0.05) There was an obvious difference in patients’age and the blood loss during operation in a statistically significant way (P<0.05)②The Harris evaluation of Artificial replacement of hip joint Group was better than internal fixation Group one month and three months after operation, because of the obvious difference between the two groups, statistical significance existed (P<0.05).There was no statistical significance (P>0.05) which had no obvious difference in Harris evaluation between the two groups12months after operation. The excellence rate of Artificial replacement of hip joint Group was higher than internal fixation Group (P=0.012. It took Artificial replacement of hip joint Group less time to reach an excellence rate than internal fixation Group (P=0.001) The good rate of the two groups were close (P=0.052).It took less time in Artificial hip replacement Group to reach a good rate than internal fixation Group (P=0.000)Conclusions:To treat femoral intertrochanteric fractures by artificial hip replacement, in which the hip function is restored well, it took less time either for reaching an excellence rate or stay in bed, of which the risk during operation and postoperative complications are equivalent to the internal fixation Group, is one of doable choice to cure femoral intertrochanteric fractures in the oldest old.