Cemented Hip Arthroplasty For Unstable Intertrochanteric Fractures In Elderly Patients

Objective:To discuss the surgical technique and efficacy of the cemented hip arthroplasty for unstable intertrochanteric fractures in elderly patients. Methods:Twenth-nine elderly patients with unstable interthochanteric fractures were treated with cemented hip arthroplasty, including13males and16females with an average age of78.5years (ranging from61to94years).The time of operation,intra-operative blood loss,blood transfusion volume, thigh pain,incidence of early postoperative complications, mortality and Harris score of hip joint were registered.Clinical and radiographic evaluations were performed preoperatively. postoperatively, at one and half, three,six,twelve months,and yearly thereafter.According to the Evans-Jensen classification,there were6cases of type Ⅱ A,10of type Ⅱ B,and13of type Ⅲ.Osteoporosis was classified in accordance with the Singh index, there were9of Ⅲ,14of Ⅱ and6of Ⅰ.Results:The average operation time was78min(ranging from51to90min).The mean blood loss during the operation was410ml(ranging from300to600ml).One of the patients died during the follow-up. The other28patients were followed up with an average of18.6months(ranging from5to30months).The patients were able to walk with crutches about1day postoperatively.One and half months after the operation,the ability to walk was almost the same as pre-injury level in24cases.The acetabular wear, the prosthetic loosening and subsidence were not found.The complications included1case of cerebral infarction,2cases of deep venous thrombosis and2heterotopic ossifications.According to Harris hip score,6cases were classified as excellent,18cases as good,4cases as fair and1case as poor.Conclusion:The short-term results of cemented hip arthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.