A comparative analysis between joint arthroplasty and intramedullary nail fixation of 83 geriatric elderly patients with femoral intertrochanteric fractures
WANG Xuan
ZHANG Ru-jin
MA Wen-ming
HE Shuang-hua
Abstract：Objective To analyze the clinical data of artificial hip replacement and internal fixation for complex femoral intertrochanteric fractures, and to evaluate the effects of different operative methods on the prognosis. Methods The data of 83 patients with femoral intertrochanteric fractures who were adopted and treated from January 2008 to December 2011 were collected and observed, with the age of over 70 years old. The perioperative information of the patients who were treated with artiifcial hip replacement and internal ifxation respectively was recorded and analyzed. The data were collected and processed using the Micro Soft ( MS ) Excelland statistical product and service solutions ( SPSS ) 17.0. The measurement data were recorded as Mean ± standard deviation ( SD ). Differences between the 2 groups were compared with the independent-samples t-test, and differences of items in the same group were compared with the paired-samples t-test. The enumeration data between the 2 groups were compared with conventional or updated chi-square tests. When the P value was less than 0.05, the differences were considered to be statistically signiifcant. Results Among the 83 patients, 45 patients were treated with cemented hip arthroplasty, whose average age was ( 79.2±7.6 ) years old, including 24 males and 21 females. The average operation time was ( 75.4±18.5 ) minutes. The mean bleeding volume was ( 320±75.6 ) ml. The average hospital stay was ( 8.9±2.1 ) days and the average bedridden time was ( 7.8±2.7 ) days. 38 patients were treated with internal ifxation, whose average age was ( 78.6±7.3 ) years old, including 21 males and 17 females. The average operation time was ( 71.5±25.6 ) minutes. The mean bleeding volume is ( 290±65.4 ) ml. The average hospital stay was ( 9.2±2.3 ) days and the average bedridden time was ( 9.2 ±2.3 ) days. Even through the bleeding volume in the group treated with cemented hip arthroplasty was larger than that of the group treated with internal ifxation, and the average operation time was longer, there were no statistically signiifcant differences between them. The bedridden time in the group treated with cemented hip arthroplasty was longer than that of the group treated with internal ifxation, and there were statistically signiifcant differences between them. When the Harris scores of the 2 groups were compared at 1, 3 and 6 months postoperatively, the group treated with cemented hip arthroplasty was obviously superior to the group treated with internal ifxation, and the differences between them were statistically signiifcant. Conclusions Artiifcial hip replacement for complex femoral intertrochanteric fractures can effectively restore the joint function and help the patients leave the sickbed early, with few complications caused by a long-term bed rest. Due to the complexity of the arthroplasty and possible complications, indications should be properly mastered, and preoperative comprehensive assessment and preparation are necessary.
Keywords：ArthroplastyreplacementhipFracture ifxationintramedullaryFracturesboneFemoral fracturesHip joint
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 627-631 )