Application of semi-hip replacement combined with wire cerclage in elderly patients with unstable intertrochanteric fractures

LIU Chao-jian; CAI La-jia; SHI Zhao-hong; LIN Jian-xiong

doi:10.3969/j.issn.1009-4237.2016.05.007

Abstract：Objective To study the clinical effect of semi-hip replacement combined with wire cerclage for elderly patients with unstable intertrochanteric fractures.Methods Clinical data of 40 elderly patients diagnosed with unstable intertrochanteric fractures undergoing cemented hip replacement combined with wire cerclage were ana-lyzed retrospectively.Among them 17 were male and 23 were female with an average age of ( 82.2 ±4.8 ) years (75-90 years) .The operation time,operational blood loss,incision length,ambulation time,post-operative drianage vol-ume,healing time and full weight-bearing time were analyzed and the hip joint function was evaluated. Results All the 40 patients completed the surgery successfully and all incisions achieved good healing;the postoperative follow-up time was 9 to 12 months,averaging (11.3 ±1.2) months.The average operative time was (128.4 ±17.4) min, blood loss was (309.3 ±43.2) mL,incision length was (14.2 ±2.4) cm,postoperative ambulation time was (13.5 ±2.9)d,postoperative drainage was (296.8 ±98.4) mL,fracture healing time was (4.1 ±0.7) months,and the full weight-bearing time was (4.6 ±0.5) months.At the last follow-up,the hip joint function was excellent in 14 ca-ses,good in 16 cases,fair in 8 cases and poor in 2 cases,with an excellent and good rate of 75.00%.Conclusion Semi-hip replacement combined with wire cerclage for the treatment of unstable intertrochanteric fracture in the elderly has reliable effect,fewer complications,while needs long time of surgery and results in large amount of bleeding.Some elderly patients may not be suitable for this surgery.