Clinical Study Of Hemiarthroplasty In The Treatment Of Intertrochanteric Fractures In The Elderly Patients

Purpose:To compare the clinical and radiological results between internal fixation and hemiarthroplasty in reverse oblique intertrochanteric hip fractures in elderly patients and provide more references for the choice of treatment methods for the elderly intertrochanteric fractures Methods:From May 2014 to May 2016,A retrospective analysis of 32 cases of elderly intertrochanteric fractures using hemiarthroplasty and 56 patients treated with intramedullary fixation system(Gamma3)in Qingdao municipal hospital.The clinical data of 32 elderly patients with intertrochanteric fracture treated with selective artificial joint replacement and 56 patients treated with intramedullary fixation system(Gamma3)in Qingdao Municipal Hospital.The average follow-up period was 24.8 months.According to AO classification criteria,the fracture data of the two groups were classified.The operation time,intraoperative bleeding volume,total weight-bearing time,hospitalization time,incidence of complications and reoperation rate of the two groups were recorded respectively.The Harris score and VAS score of the two groups at 3,6,12 and 24 months after operation were recorded respectively.Statistical data of the two groups were analyzed by SPSS21.0 data analysis software.The measurement data were expressed as ±s.The measurement data were tested by independent sample complete random t test,and the counting data were tested by ?2 test.P < 0.05 is the difference with statistical significance.Result:The intraoperative blood loss in the hemiarthroplasty group was 340.94 ± 35.23 ml,which was more than 236.96±28.92 ml in the internal fixation group(P<0.05).However,the incidence of complications in the hemiarthroplasty group was 6.25%,and the time to recover full weight bearing was 12.34 ± 1.77 days,which was better than 23.2% and62.18 ± 4.71 days in the internal fixation group respectively,(P<0.05).The Harris scores of the hemiarthroplasty group in 3 and 6 months postoperatively were 71.81 ±2.93 and 79.06 ± 2.03 respectively,which were better than the internal fixation group(59.14 + 2.67)and 68.91 + 2.16,(P<0.05).The scores of two groups in 12 months postoperatively were 80.19 ± 1.28 and 79.71 ± 1.90 scores,(P>0.05).24 months after operation,88.92 ± 2.08 points in internal fixation group better than 80.35 ±3 in the hemiarthroplasty group(P<0.05).In VAS score,the 4.78±0.87 points in the replacement group were superior to those in the internal fixation group5.98±1.05(P<0.05),and 3and 6 months after the operation,There was no statistical difference(P>0.05).In 24 months after operation,2.98 ± 0.70 in the internal fixation group was superior to that in the replacement group 4.32 ± 0.70(P<0.05)Conclusions:Hemiarthroplasty can be applied to the treatment of intertrochanteric fractures in the elderly selectivity,especially for patients with bad health and poor bone quality,and can not stay in bed for a long time,and can allow patients to move down to the ground early and reduce the incidence of postoperative complications than internal fixation,and the postoperative functional recovery is reliable...