The Treatment Effect Of Two Different Renovations In The Treatment Of Intertrochanteric Fracture With Intramedullary Fixation Failure

Objective:Through a retrospective case study,the clinical efficacy of two different renovations(re-intramedullary fixation and total hip arthroplasty)for intertrochanteric fracture with internal fixation failure was discussed.Methods:To collect the medical history and imaging data of the patients who failed to treat intertrochanteric fracture of femoral intertrochanteric fracture from March 2015 to March2017,and analyze the causes of failure.The VAS pain score and Harris hip function score were collected through outpatient,telephone or network follow-up methods for the patients undergoing revision and final follow-up(1 year after revision surgery).Results:All patients completed the revision surgery successfully,and the follow-up period was 6 to 15 months.There were 14 patients with re-intramedullary fixation,all fractures healed,and the healing time was 5 to 8 months,and 1 case was combined with proximal femoral pain.The function score of Harris hip joint was 80.87 ±1.4,P < 0.05,from 36.87±4.2 to 1 year after revision.Total hip arthroplasty was performed in 19 failed patients.One patient died of lung disease six months after surgery.The function score of Harris hip joint was 83.57 ± 2.5,P < 0.05,from 38.73 ±2.8 to 1 year after revision.The functional score of Harris hip joint was compared with P < 0.05 after two renovations.Conclusion:re-intramedullary fixation and total hip arthroplasty in the treatment of intramedullary fixation failed femoral fractures were obtained satisfactory curative effect between the rotor and revision total hip arthroplasty after 1 year Harris hip score better function,better recovery of hip function 1 year.However,the original femoral head and neck were retained in the re-intramedullary fixation,which was more consistent with the physiological anatomical features of the rotor.Therefore,in clinical practice,we can choose the reconstruction method according to the specific reasons of the failure of the patient's intramedullary fixation,and choose the reconstruction method rationally,accelerate the fracture healing,and improve the patient's quality of life.