| Objective:To compare the therapeutic effect and complications of locking plate internal fixation and joint replacement for treatment of Evans-Jensen Ⅱ Ⅲ type intertrochanteric fractures in the elderly.Methods:(1) A retrospective analysis was conducted on patients with intertrochanteric fractures treated in our hospital from? April2010to December2012.(2) They were divided into locking plate internal fixation group and the joint replacement group according to different surgical methods. A total of53patients were observed and followed up, including29cases in the locking plate internal fixation group and24cases in the joint replacement group.(3) The patients’hospital stays, duration of operation, ambulation time and occurrence of complications were recorded. After surgery for one month, three months, six months and twelve months, the hip joint functions, capability of daily living activities and occurrence of complications in patients were followed up.(4) A comparative analysis was conducted on the data of preoperative general conditions, postoperative hip joint functions, Barthel index score on the capability of daily living activities, and the occurrence of complications.Results:(1) The duration of operation in the joint replacement group was shorter than that in the internal fixation group, and the postoperative ambulation time was earlier than the internal fixation group; the differences were statistically significant (P<0.05). However, the hospital stays were not statistically significant between two groups (P>0.05).(2) The differences in the incidences of non-implant-related complications, implant-related complications and total complications were not statistically significant between two groups (P>0.05).(3) After surgery for one month, three months, six months and twelve months, the Harris scores of hip joint in the joint replacement group were higher than those in the locking plate internal fixation group, and the differences were statistically significant (P<0.05).(4) After surgery for one month, three months, six months, the Barthel index scores in the joint replacement group were higher than those in the locking plate internal fixation group, and the differences were statistically significant (P<0.05). However, after surgery for twelve months, the Barthel index score in the joint replacement group was slightly higher than that in the locking plate internal fixation group, and the difference was not statistically significant (P>0.05). Conclusion:(1) The joint replacement for treatment of Evans-Jensen Ⅱ Ⅲ type intertrochanteric fractures in the elderly patients can achieve better hip joint functions and activities of daily living in the postoperative early period.(2) The difference in the occurrence of complications was not statistically significant between the joint replacement and locking plate internal fixation. |
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