Comparision Of The Effects Of Fixation And Arthroplasty On The Treatment Of Intertrochanteric Fractures In Elderly Patients

Objective: To compare the effects of fixation and arthroplasty on the treatment of intertrochanteric fracture in elderly patients and provide practical advice for the clinicians.Methods: From January 2012 to March 2014, 260 patients aged 60 or older with intertrochanteric fracture admitted to Department of Trauma and Orthopaedics, Affiliated Nanhua Hospital, University of South China, were included in this study. All patients were divided into two groups according to treatment modes, arthroplasty group(182 cases) and fixation group(78 cases). 123 patients in arthroplasty group underwent hemiarthroplasty surgery and 55 total hip arthroplasty. 28 patients in fixation group underwent DHS fixation, 19 locking plate fixation and 35 PFN internal fixation. Indices for evaluating effects of the two groups included blood loss, operative time, blood transfusion after surgery, bed time, postoperative ambulation time, complications, and postoperative hip Harris scores were collected and analyzed.There were significantdifference among blood loss, blood transfusion after surgery, bed time, and time after full weight bearing in the two groups(P <0.05), but the difference between arthroplasty group and fixation group in operative time did not reach statistical significance(P> 0.05).Frequency of complications in arthroplasty group was more decreased than fixation group(P <0.05).Harris hip scores in arthroplasty group were significantly higher than fixation group at 1, 3, 6, and 12 months after surgery(P <0.05).Conclusions:(1) Compared with internal fixation, elderly patients with senile femoral fractures who underwent arthroplasty have less blood loss and blood transfusion during operation, lower incidence of complications, and with better security.(2) compared with internal fixation, elderly patients with femoral fractures who underwent arthroplasty have shorter postoperative time, more early load time off bed,more faster recovery of hip function, and more higher total effective rate. arthroplasty is one of viable option for the elderly patients with femoral fractures..