Comparative research of clinical effect of intramedullary fixation and hip replacement in treating senile reverse obliquity intertrochanteric fractures

WANG Gang

doi:10.3969/j.issn.1009-4237.2018.01.011

Abstract：Objective To compare the clinical effects of the treatment of senile reverse obliquity intertro-chanteric fractures(ROIF) between intramedullary fixation and hip replacement .Methods Totally 132 elderly ROIF patients were retrospectively analyzed ,who were treated in our hospital from Jun .2014 to Apr.2016.There were 39 males and 93 females,with an average age of (81.36 ±7.18) years.Patients were divided into hip replace-ment group(group A,n=72) and proximal femoral nail antirotation (PFNA) group (group B,n=60) according to the methods of operation .The operation time , intraoperative blood loss , full weight-bearing time , length of hospital stay,postoperative Harris scores and related complications were recorded and compared between two groups .Re-sults The level of HgB after operation in group A was 82.49 ±6.52 g/L,which was lower than that in group B (91.52 ±7.41g/L,P<0.05).The operation time in group B ((67.23 ±6.42 ) min) was significantly less than that in group A ((82.12 ±8.56) min,P<0.05).The average time of the full weight-bearing was (21.52 ±3.54 ) d and (38.41 ±7.68)d in group A and B,respectively,which had significant difference (P<0.05).However,there was no difference among the scores of physical function ,body pain,general health,vitality,social function,emotion and mental health ( P >0.05 ) .Also, no statistical difference was observed in the complications between the two groups(P>0.05).Conclusion The clinical effects of the treatment of ROIF between intramedullary fixation and hip replacement are similar .However ,the intramedullary fixation is more suitable for the elderly ROIF patients due to its advantages such as less intraoperative blood loss and shorter operating time .