| Objective: to evaluate the efficacy and safety of artificial hip arthroplasty in the treatment of osteoporotic intertrochanteric fracture of femur.Methods: a retrospective study was conducted in elderly patients with osteoporotic intertr-ochanteric fracture of femur who were admitted to the first Hospital of Lanzhou University from January 2011 to october 2018.82 subjects were divided into artificial hip replacement group and PFN-A internal fixation group according to different surgical methods.There were 41 cases in each group.65 cases were female,17 were males,the youngest was 76 years old,and the maximum age was 94 years old.The average age was 85.62 years old;Singh index score was used to evaluate the recovery of osteoporosis after operation,and dual energy X-ray examination was performed when necessary,according to Harris.The hip joint score was used to analyze the prognosis of the patients and collect the corresponding data.The follow-up or follow-up time was at least one year.The operation time,blood loss during perioperative period,weight loading time after operation,average hospitalization days,preoperative,early and late joint function,postoperative complications and so on were collected by means of consulting cases and telephone visits.The statistical software adopts SPSS version 22.0.For the measurement data,the variance homogeneity test,that is,the Levene test,is carried out first.When P >0.1 means that the variance of two samples is equal,that is,homogeneity of variance,then the independent sample T test is used,and when P < 0.1 means two samples.The deviation was not uniform and Cochran&Cox approximation T test was used.Measurement data: mean ±standard deviation(X ±S).For counting data,different card-square test was used according to the difference of total(n)and frequency(T)included in the study:(1)when n ? 40 and all T ? 5,Pearson card-square test wasused;(2)if n ? 40 but there is 1 ? T ? 5,continuous correction card square test is used,(3)when n ? 40 or T ? 1,Fisher exact probability method is used.Survival analysis: Mantel-Cox test was used.(P < 0.05): difference There is statistical significance.Results: 1 according to the operation time,the amount of blood lost during operation,the time of weight loading and the days of hospitalization to evaluate the safety of the two groups,it is concluded that the operation time of the artificial hip replacement group is the same as that of the artificial hip replacement group.The amount of intraoperative bleeding was significantly higher than that of PFN-A fixation group.It could be concluded that the time of artificial hip replacement was longer and the amount of intraoperative bleeding was more.2 Harris hip score was performed before operation,3 months after operation,6 months after operation and12 months after operation.Through the data analysis,we can know: the Harris score of the patients before admission,3 months after operation,6 months after operation,There was no significant difference between the two groups(P > 0.05).There was a significant difference between the Harris score of the artificial hip replacement group and that of the PFN-A internal fixation group 12 months after operation.Artificial hip replacement is beneficial to the long-term recovery of hip function.4 among 82 patients in this study,in the artificial hip arthroplasty group,2 patients had infection symptoms(1 pulmonary infection,1 urinary tract infection),1 patient had periprosthetic fracture phenomenon,2 patients had thigh pain.PFN-A group: 1patient underwent surgical resection oral infection,pulmonary infection in 1 patient,swelling and pain in lower extremity in 1 patient,early deep venous thrombosis in 2patients,bedsore in 2 patients,joint loosening in 2 patients,thigh pain in 3 patients after operation.The statistical analysis showed that the P value of all the results was greater than 0.05,which indicated that there was no difference in the occurrence of postoperative complications between the two types of operation.5 to compare the effectiveness of postoperative treatment between the two groups,this study first carried out chi-square test on the rate of excellent results in the study of 3 and 12 months,respectively.The results showed that har was obtained at 3 months,6months after operation and 12 months after operation respectively.There was no significant difference in ris score between the two groups.There was no significant difference in the short-term and long-term Harris score between the two groups.In this study,the survival rate of the patients with Harris score > 90 at 3 and 12 monthsafter operation was analyzed by survival analysis.The statistical analysis showed that X = 4.418 g P < 0.05,the difference was statistically significant.Artificial hip replacement is superior to PFN-A in the long-term recovery of hip joint.Conclusion: although artificial hip replacement may lead to longer operation time and more intraoperative bleeding,the advantage of other safety indexes(weight loading time,length of stay)is more obvious.Although artificial hip arthroplasty has no obvious advantage over PFN-A internal fixation in short term hip function recovery,it has a positive effect on the long term postoperative hip function recovery.This is helpful for the elderly patients with osteoporotic intertrochanteric fracture to recover the limb activity as soon as possible,to make the hip joint function in the best condition as soon as possible,to reduce the occurrence of complications,and to improve the ability and quality of life of the elderly patients with osteoporotic intertrochanteric fracture. |
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