| Objective:To investigate the curative effect of Biotype Longer-stem Artificial Femoral Head Replacement to the treatment the elderly patients with unstable intertrochanteric fracture.Materialsand Methods: Using retrospective analysis method,A total of 32 elderly patients with unstable intertrochanteric fracture were treated in the second hospital of Dalian medical university from March 2012 to March 2014.Including 10 cases of males and 22 cases of females with an average age of 84.34±3.308 years(rang 79-98 years). There were all fresh fractures,including 6 cases injured by traffic accident and 26 cases by carelessly injured. Fracture type according to the Jensen-Ewans score points(1975), all of they were unstable, Ⅲ type in 11 cases, and Ⅳ type in 15 case s and V type in 6 cases. Assessment of osteoporosis using Singh index, 12 cases were Grade Ⅲ, 16 cases were Grade, and 4 cases were Grade. There were 20 cases of patients with high blood pressure, 14 cases of patients with coronary heart disease, 11 cases of patients with diabetes,6 cases of patients with cerebrovascular disease, 5 cases of patients with chronic lung disease, 3 cases of patients with other chronic disease, All of the patients before the injured can walk or to walk on crutches. All the patients were treated with biotype Longer-stem artificial femoral head replacement, Record preoperative Harris hip score and postoperative follow-up for half a year and a year the Harris hip score, Evaluation the clinical efficacy and safety through clinical and radiographic.Results:The average surgery time was(62.87±5.752) min,the interoperative bleeding volumes(324.06±69.293)ml. the postoperative drainage volume(133.06±34.223) ml,the postoperative ambulation time(4.41±1.434) days,the length of hospital stay(13.59±2.340) days and the follow-up time(10.87±4.078)months. Preoperative Harris score:7.34±4.749, postoperative 6 months Harris score 71.47±11.083, postoperative 1 year Harris score 84.22±8.537. According to postoperative 1 year Harris score of the hip joint,including excellent 14 case,good 12 case,medium 4 case,bad 2 case,fine rate was 81.25 %and the satisfaction of patients was 100%. This group of cases of preoperative and postoperative 1 year Harris score difference was statistically significant(P<0.05),postoperative 6 months Harris score and postoperative 1 year Harris score difference was statistically significant(P<0.05). All of the patients of postoperative incision healed well, basic isometric postoperative double lower limbs, vary in the range of 1cm.there were 3cases with different degrees of lung infection and 1case mental disorder by the medical treatment were cured. Postoperative follow-up no peri-prosthetic fracture,infection,artificial joint dislocation,sinking of prosthesis loosening,etc.Conclusion:Biotype longer-stem artificial femoral head replacement surgery time is shorter, less the intraoperative bleeding, good recovery of hip function, early postoperation the down time, little postoperative complication,biotype longer-stem artificial femoral head replacement for the treatment of aged patients with unstable intertrochanteric fracture with osteoporosis and medical complications of chronic diseases is a safe and efficient method. |
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