Application Of Greater Trochanter Reattachment And Arthroplasty In Elderly Patients With Intertrochanteric Fracture

Objective:To observe the clinical effects of greater trochanter reattachment(GTR) device combined with arthroplasty for unstable intertrochanteric fractures in elderlies with severe osteoporosis.Methods:From September 2013 to September 2014, a total of 48 patients diagnosed with severe osteoporosis and suffered intertrochanteric fracture, type IV or V according to Evens-Jensen classification, were recruied as the research objects. All patients received cementless hemiarthroplasty, 21 cases using GTR devices to stabilize the unstable intertrochanteric fracture fragments(Group A), and 27 cases were fixed by cerclage wires(Group B). There was nosignificant difference in age, gender,side and Evens-Jenson style between two groups(P>0.05). Analysis of the time of the operation, the time of the first post-operative walking, postoperative complications, the abductor muscles strength of the hip, and postoperative Harris Hip Scores in special time(1 month, 3 month, 6 month, and 1 year). Results:Compared the data of the two groups, Group A was significantly better than Group Bin the time of the operation, the time of the first post-op walking, and the Harris Hip Scores of patients 1 month after surgery(P < 0.05).Complications were found in one and five cases in Group A and Group B respectively. The rate of postoperative complications is lower in Group A(4.76%) compared with Group B(18.52%). There was no significant difference in Harris Hip Score 3 month, 6 month and 1 year after surgery(P>0.05). Conclusion:Internal fixation usually is the first choice for those elderly patients who had been diagnosed with severe osteoporosis and suffered intertrochanteric fracture, but for those who choose arthroplasty patients,We find that arthroplasty combined with GTR is a good option for reconstructing greater trochanter fracture fragments.This technology can reduce the time of operation, shorten the in-bed time promote early functional exercise and improve hip function restoration. So that it decreased the complications related to long-term bed rest and improve patient’s quality of life.