The Clinical Effect Of The Treatment For Distal Stable Cementless Stem To Unstable Intertrochanteric Fractures In Elderly Patients

Objective:By comparing to observe the clinical effect of distal stable cementless stem for unstable intertrochanteric fractures in elderly patients.Method:Totally 52 elderly patients with unstable intertrochanteric fracture were treated with hemiarthroplasty from may 2012 to may 2104,with an average age of 78.2 years,all of them were treated with hemiarthroplasty,they were divided into two groups randomly, 28 patients were treated with distal stable cementless stem,There were 9males and 19 females with an average of 78.2 years(rang 70-95years),They were all unstable fractures according Evans classification,12 cases were type III, 9 cases were type IV, 7 cases were type V, 27 of them have different based disease; 24 cases were treated with cement stem, There were 8 males and 16 females with an average of 77.3 years(rang70-96years), They were all unstable fractures according Evans classification,9 cases were type III, 8 cases were type IV, 7 cases were type V, 23 of them have different based disease; They were followed-up for average 27 months(range 12-36months);to compare the clinical effect of two groups,through analysis the data of two groups of patients data.Result:The operation time of the distal stable stem group is shorter than cemented long-stem group(P<0.05).The intraoperative blood loss of the distal stable stem is less than cemented long-stem group(P<0.05)..Theintraoperative, Fluctuation of blood pressure of the distal stable stem group is smaller than cemented long-stem group(P<0.05). The time of weight-bearing and incidence of postoperative complications were no statistical difference between the two groups after operation(P>0.05). The prosthesis of two groups were not observed shifting,sinking and loosing after surgery. Harris scores of the distal stable revision stem group has no difference to cemented long-stem group(P>0.05).Conclusion:When using distal stable cementless femoral stem and a cemented femoral plus long-handled artificial femoral head replacement for the treatment of senile intertrochanteric fracture, they both can make patients with early ambulation, relieve pain in patients, avoid prolonged bed rest,hold the objective to restore the function of hip joint. but stable distal stable cementless femoral stem hemiarthroplasty shorter operative time,less blood loss, heart rate, blood pressure, oxygen saturation of intraoperative is less volatile, avoid bone cement reaction. Therefore, for patients with osteoporosis among the elderly unstable intertrochanteric fractures, distal stable cementless femoral stem hemiarthroplasty is an ideal surgical approach.