Observation of Effect of Novel Combined Minimally Invasive Semi-hip Re-placement in the Treatment of Senile Osteoporotic Intertrochanteric Frac-ture of Femur

LI Yinpeng; WANG Yin; HAO Ming; CAO Bin; LI Ximing

doi:10.3969/j.issn.1002-3429.2024.17.010

Abstract：Objective To explore the efficacy and safety of novel combined minimally invasive semi-hip replacement in the treatment of senile osteoporotic intertrochanteric fracture of femur.Methods A total of 102 elderly patients with osteo-porotic intertrochanteric fracture of femur treated from January 2019 to January 2023 were selected and divided into three groups with 34 patients in each group using 1∶1∶1 pairing principle.Patients who underwent minimally invasive semi-hip replacement were selected as the minimally invasive group,patients who underwent artificial joint replacement were selected as the joint replacement group,and patients who underwent proximal femoral nail antirotation(PFNA)internal fixation were se-lected as the internal fixation group.The operation-related indexes,stress response indexes[adrenocorticotropic hormone(ACTH),norepinephrine(NE),epinephrine]before and after operation,Harris score,excellent and good rate of hip recov-ery,postoperative complication rate and readmission rate of the three groups were compared.Results The duration of opera-tion,total incision length,intraoperative blood loss,postoperative drainage volume,time of postoperative off-bed activity,length of hospital stay and fracture healing time in minimally invasive group and internal fixation group were shorter or less than those in joint replacement group(P＜0.05).The levels of ACTH,NE and epinephrine in minimally invasive group and inter-nal fixation group were lower than those in joint replacement group(P＜0.05).At 6 months and 12 months after surgery,the Harris scale pain,function,joint motion and limb deformity scores of the three groups were compared,showing the highest scores in minimally invasive group,followed by internal fixation group and joint replacement group(P＜0.05).At 12 months after operation,there was no significant difference in the excellent and good rate of hip function recovery among the three groups(P＞0.05).The rates of complications and readmission at 12 months after surgery in the minimally invasive group and the internal fixation group were lower than those in the joint replacement group(P＜0.05,P＜0.01).Conclusion Com-pared with artificial joint replacement in the treatment of senile osteoporotic intertrochanteric fracture,the new combined mini-mally invasive semi-hip replacement and PFNA can optimize the surgical process,improve the surgical safety,lower the risk of readmission,reduce the stress reaction and promote fracture healing,but the former has a better effect on improving hip func-tion.