Analysis of the efficacy of hip arthroplasty based on soft tissue fixation in the treatment of osteoporotic intertrochanteric femur fractures in the elderly

ZHU Yi-chen; SHEN Shi-yun; JIA Chong; LI Jian-you

doi:10.3969/j.issn.2095-252X.2025.12.004

Abstract：Objective To evaluate the clinical efficacy of hip arthroplasty(HA)based on soft tissue fixation of the greater trochanteric fragment for treating osteoporotic intertrochanteric femoral fractures(IFF)in elderly patients.Methods This retrospective study analyzed the clinical data and outcomes of 36 elderly patients with osteoporotic IFF treated with soft tissue fixation combined with artificial HA from March 2018 to April 2024.The cohort study included 7 males and 29 females,with a mean age of(84.36±6.77)years.Left-sided cases numbered 19,while right-sided cases numbered 17.Surgical procedures included 8 total hip replacements and 28 hemiarthroplasties.Fractures were classified using the Evans-Jensen system,with 22 cases classified as type Ⅲ and 14 as type Ⅳ.Fractures were classified using the AO/OTA system,with 24 cases classified as 31A2.2 and 12 as 31A2.3.Preoperative and postoperative parameters,Harris Hip Scores(HHS),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,and complication rates were recorded and analyzed.Results The mean follow-up duration was 21.06 months(range:6-48 months).The mean operative time was(62.17±11.51)min,with a mean postoperative hemoglobin loss of(19.53±6.98)over 3 days.Patients resumed walking at a mean of(2.42±1.42)days postoperatively,and the mean hospital stay was(9.33±1.69)days.At the final follow-up,significant improvement was observed in HHS and WOMAC scores(P=0.000;P=0.002).Imaging results confirmed satisfactory fracture healing,and the 1-year postoperative mortality rate was 5.51％.Conclusions HA based on soft tissue fixation for osteoporotic IFF in elderly patients offers advantages such as lower surgical difficulty,reduced surgical trauma,and effective fixation It allows patients to get out of bed early for weight bearing with favorable early clinical outcomes.