Therapeutic Analysis Of Corail Bioprosthetic Femoral Head Replacement For The Theatment Of Evans ? And ? Intertrochanteric Fractures In Elderly Patients

Objective:To analyze the clinical effect of Corail bioprosthetic femoral head replacement for the treatment of Evans III and IV in elderly patients with femoral intertrochanteric fractures.Methods:Retrospective analysis of 78 elderly patients was done with Evans ? and ? femoral intertrochanteric fractures treated in the department of orthopedics,Yanbian University Hospital,from September 2015 to June 2017.The patients were randomly divided into two groups,which were treated with Corail bioprosthetic femoral head replacement(group of replacement,n=40)and treated with PFNA(group of PFNA,n=38).According to the Tronzo-Evans classification,48 cases were of type ? and 30 were of type ?.In the group of replacement,there were 28 cases of Evans type ?and 12 cases of Evans type ?,whereas,In the group of PFNA,there were 20 cases of Evans type ?and 18 cases of Evans type ? Among all the cases,a simple fall was the main cause of the fracture except for 5 cases of motor vehicle accident and 3 cases of fall from height.All the cases presented were closed fractures.The operation time,hospitalization period,postoperative weight bearing and mobilization time,postoperative complications,postoperative hip joint Harris score at 1st,3rd and 6th month,and the excellent and good rate of the patients at the 6th month after operation were analyzed.Result:All patients were followed up for 8-12 months,with an average of(10.25+1.78)months.The incisions of the two groups were all healed by primary intention.There was no statistical difference between the two groups before the operation(P>0.05),such as sex,age,Tronzo-Evans typing,injury factors,the location of the disease and bone mineral density.There was no significant difference in the operation time between the group of replacement and group of PFNA(P>0.05).Postoperative weight bearing and mobilization time of the group of replacement was(5.9+3.1)days and the group of PFNA was(12.3+2)days,the time difference between the two group was statistically significant(P<0.05).The hospitalization time of the group of replacement was(8.3+1)days and the group of PFNA was(10.3+1.6)days,the hospitalization time between two groups was statistically significant difference(P<0.05).There were 3 complications in the group of replacement and 9 in the group of PFNA(P<0.05).The incidences of complications were 7.5%in the group of replacement and 23.6%in the group of PFNA.There was a significant difference in the number of postoperative complications and the incidence of complications between the two groups(P<0.05).Harris scores of the group of replacement at the 1 st,3rd and 6th month after operation were 61.21 ±4.9,74.4 ±3.9 and 91.0 ±3.1,the group of PFNA was 38.26 ±2.6,60.7 ±2.5 and 84.2± 3.4.There was a significant difference between the two groups(P<0.05).According to the Harris score of the patients at the 6th month after the operation,the excellent and good rates were 87.5%in the group of replacement and 65.7%in the group of PFNA.There was a significant difference between the two groups(P<0.05).Conclusion:Corail bioprosthetic femoral head replacement in the treatment of Evans ? and ?femoral intertrochanteric fractures in elderly is effective and can significantly improve the quality of life of patients.