Compare And Explore The Arthroplasty With Internal Fixation For Intertrochanteric Fractures In Elderly Patients

Objective To compare the outcomes of elderly patients withintertrochanteric fracture which treated by artificial hip arthroplasty andinternal fixation,and explore hao to choose these two methods.Methods Collecting the clinical datas of95elderly patients withintertrochanteric fracture treated by hip arthroplasty and internal fixationfrom January2009to January2012in our hospital.For generalinformations,operative time,blood loss,mean length of stay,postoperativecomplications and outcomes according to Harris hip score were comparedand analyzed.Results A total of95cases were selected,aged from65to93years,mean age76±4.6years.45cases in arthroplasty group,mean age77.2±4.8years,42%aged over80years,16%aged over85years.50cases in internalfixation group,mean age74.8±4.1years,26%aged over80years,8%aged over85years.The main mechanism of injury was fall(92.6%).There wereno significant difference between two groups in general informations andcan be compared.There were significant differences between the twogroups that internal fixation group had less operative time and amount ofblood lost.The mean length of stay was not significant different betweentwo groups.All these patients were followed-up from12months to36months.The rate of postoperative complications was13.3%versus30%,that arthroplasty group displayed advantages compared with internalfixation group. There was no significant difference between two groups inHarris hip scoore(arthroplasty group93.3%versus internal fixation group90%).Conclusion Preoperative evaluation is very important for elderlypatients with intertrochanteric fractures. Patients with advancedages,comminution, accompanied by severe osteoporosis, poor compliance,artificial hip replacement is an effective operation method. On the premiseof good reduction and fixation, internal fixation can achieve good results.