Clinical Study Of Artificial Hip Replacement In Thetreatment Of Intertrochanteric Fractures In The Elderly

Objective: By comparing and analyzing two kinds of operation method(artificial hip replacement surgery and internal fixation surgery)to treat old age,merging medical disease,crushing more complex and more osteoporosis of the clinical effect of the treatment of intertrochanteric fractures between rotor and early complications,to explore the feasibility and practicability of artificial hip replacement for osteoporosis intertrochanteric fracture of underlying medical illness,crushing more complex.Methods: A total of 80 cases of intertrochanteric fractures treated in The Second Hospital Of Lanzhou University and Lanzhou Petrochemical General Hospital during January2010—December 2014,were selected.Among them,36 cases were male and 44 were female.Age70—93 years old,average 83.6 years old.Divided: group A according to the operation mode,namely artificial hip joint replacement group(n=40),extended stem bipolar bipolar artificial femoral head replacement in 32 cases,including 26 cases of biological type,6 cases of bone cement type;8 cases of total hip replacement,for biological type;group B internal fixation group(n=40),the gamma nail,DHS,PFNA and LCP were 10 cases.The operation time,length of stay,time of operation,amount of bleeding during operation,postoperative complications and functional recovery of hip joint were recorded.The patients with sex,age,preoperative with disease,type of fracture,surgery,anesthesia,whether osteoporosis as the factors relative to the postoperative early complications,Logistic regression analysis was carried out on the above factors.Results:(1)Comparison of operation of the two groups in postoperative situation: by comparing the age,operative time,bleeding volume,operation time and hospital stay and found in the patients after time difference was statistically significant,indicating that the artificial hip joint replacement surgery has less operation after down earlier,so superior to internal fixation group.(2)After operation in the two groups clinical efficacy after hip Harris hip score and the comparison: after operation of 3 months,6 months,compared the difference of two groups of patients with Harris hip score is statistically significant and the recovery of hip function after joint replacement group were significantly better in the internal fixation group.(3)Two groups ofpostoperative early comparison: through statistical analysis of the incidence of early postoperative complications of the two groups had significant differences,that the early complications of the joint replacement group was significantly less than the internal fixation group.The patients with sex,age,preoperative with disease,type of fracture,surgery,anesthesia,whether osteoporosis as the factors relative to the postoperative early complications,single factor analysis.The results showed that the difference was statistically significant(P<0.05).The above factors are multivariate logistic regression analysis.Results show: age,preoperative combined disease,surgical approach,fracture comminution,whether osteoporosis is the independent risk factors of postoperative early complications,the or value were: 10.527,12.923,0.005,9.111,8.233.It shows that the older the patient's age,the more preoperative complications,the more comminuted fracture,the more severe osteoporosis,the greater the risk of early postoperative complications.In the operation mode,the OR value was 0.005,which showed that the joint replacement was an independent factor to reduce the early postoperative complications.Conclusion: Artificial hip joint replacement for elderly patients,medical disease more,crushing complex and osteoporosis intertrochanteric fracture,has more advantages such as less operation time,early hip joit recovery and less early complications,can yet be regarded as a good choice.