The Effect Of Femoral Offset On Hip Joint Function After Hemiarthroplasty In Elderly Intertrochanteric Fracture

ObjectiveTo investigate the effect of femoral offset on hip joint function,mobility,middle gluteal muscle function and dislocation rate after hemiarthroplasty in elderly patients with intertrochanteric fractures.To analyze the significance of reconstructing femoral offset in the restoration of the original biomechanical anatomical relationship of the hip joint with artificial joint replacement,and provide a reference for the selection of hemiarthroplasty for reconstruction of femoral offset in elderly patients.Materials and methodsThe clinical data and follow-up data of 81 elderly patients with unstable intertrochanteric fractures who underwent unilateral bipolar hemiarthroplasty from May 2016 to February 2019 in Huaihe Hospital of Henan University were retrospectively analyzed.All patients were followed up at 3,6 and 12 months after the operation.According to the difference between the femoral offset of the surgical side and the femoral offset of the healthy side after the prosthesis replacement,the patients were divided into three groups.The25 cases that femoral offset of surgical side less than 4 mm above the healthy side was defined as the unreconstructed group.The 29 cases with difference between the femoral offset of the operative side and the healthy side within 4mm was defined as the reconstructed group.The 27 cases that femoral offset of Surgical side greater than 4mm above the healthy side is defined as the increased group.There were no significant differences in age,gender,and fracture classification between the three groups(P> 0.05).The Harris score,joint mobility,middle gluteal muscle function and dislocation rate of the hip joints of the three groups of patients were regularly followed up.Statistical software(SPSS23.0)was used to statistically analyze the follow-up data of the three groups.Results1.In the three groups,the hip score of the reconstructed group and the increased group in March,June,and December were higher than those in the unreconstructed group(P <0.05);The Harris score of the increased group at 3 months after surgery was better than that of the reconstructed group(P <0.05);There was no significant difference in the Harris score between the reconstructed group and the increased group at6 and 12 months after surgery(P> 0.05).2.There was no significant difference in hip flexion and extension range of the three groups at 12 months after operation(P> 0.05);The range of hip abduction activity of the enlarged group was better than the reconstructed group and the reconstructed group was better than the unreconstructed group(P <0.05).3.In the 3 groups of patients,the prosthesis dislocation rate of the hip was tested by chi-square the results showed that the difference was not statistically significant(?2=2.338,P=0.311>0.05).Evaluated the function of gluteus medius muscle in three groups of patients,and the trendelenburg test(+)rate to perform chi-square test,the results showed that the difference was statistically significant.The abnormal rate of gluteal muscle function: unreconstructed group> reconstructed group> increased group.ConclusionWhen performing hemiarthroplasty for the treatment of elderly intertrochanteric fractures,good reconstruction of femoral offset is very important for the recovery of hip function of postoperative patients.Increasing the femoral offset within an appropriate range will be more beneficial to early recovery of hip joint function and increase the range of joint abduction activities,improve the function of gluteus medius,and reduce the incidence of postoperative gait abnormality.