The Clinical Study Of Artifical Joint Replacement For The Treatment Of Intertrochanteric Fracture In Elderly Patients

Objective To explore the feasibility and practicality of arthroplasty in elderlyintertrochanteric fracture by comparing and analyze artifical joint replacement and internalfixation in elderly intertrochanteric fracture of the early complications and clinical efficacy.Methods Gather June2008and March2012,52patients in the hospital surgicaltreatment with complete clinical data of elderly intertrochanteric fracture,there were33males and19famales,aged62-92years,average76.3years. Which interna fixation were26cases,26cases of artificial joint replacement patients. Divided into A,B groups, A=fixedgroup,B=replacement group.Detailed records of operative time,intraoperative andpostoperative bleeding, early postoperative complications, postoperative ambulation time,the degree of recovery after hip function. Hip function according to the Harris hip scorestandards.Sex,age,type of fracture, preoperative comorbidities situation,from injury to theoperative time, operation mode, anesthesia mode, operation time, as the clinical risk factorsfor early postoperative complications,To deal with univariate analysis and multi-Logisticregression analysis.Results1. The general information about A and B groups: Group A average operative timewas80.00,±15.200min, group B average operative time was88.04±8.960min, P <0.05,the internal fixation group less than joint replacement. A group of average surgicalbleeding was194.42±55.773ml average, Group B was429.42±116.570ml, P <0.05, the internalfixation group of the amount of bleeding was significantly less than joint replacement. Agroup of average patients fields was64.64±13.266d, Group B was19.46±10.599d, P<0.05, The fixed group of patients fields much later than joint replacement.2、The situation of hip function recovery after operation about A and B:All patients inboth groups were followed up for6-18months, with an average of13months. In group A,one patient was lost to follow and two cases died in8and12months after operationbecause of cerebral hemorrhage, of which6patients showed a limping gait due to hip pain.In group B, two patients were lost to follow-up and no patients died, including three casesof patients with hip pain.But no hip deformity. According to the Harris hip score:3and6months between the two groups after operation was statistically significant(P<0.05). Jointreplacement patients with the hip function recovery was better than the fixation group.3、Early postoperative complications about A and B groups:There were22patients ofPostoperative early complications.15cases in group A,there were7cases in group B, atotal of48cases.23cases have one kind of complication,18cases have two kinds ofcomplications.7cases have three kinds or more than. Postoperative early complicationswere differences statistically significant (P<0.05), joint replacement is less than the internalfixation group. By the nivariate analysis, the results show: age, preoperativecomplications,operation mode, have statistically significant difference (P<0.05). Logisticregression analysis showed that: age, preoperative complications, operation mode are theindependent factors for early postoperative complications, the OR values were1.635,54.717,0.007.Conclusion Compared arthroplasty with internal fixation for treatment ofinterthrochanteric fracture,hemiarthroplasty haa the advangtage of early postoperativeambulation, less early complication rate and well hip recovery.SO it is the effective way totreat elderly intertrochanteric fracture.