Hip replacement for comminuted femoral intertrochanteric fractures in the elderly

Abstract

Objective To discuss the clinical efficacy of hip replacement for comminuted femoral intertrochanteric fractures in the elderly patients.Methods 90 cases of femur intertrochanteric comminuted fracture from June 2010 to June 2011 were aualyzed,and divided into three groups:dynamic hip screw group( DHS ),proximal femoral nail group( PFN ) and hip replacement group,30 cases for each group,we observed the operation time,intraoperative bleeding,the hospitalization time,load time,complication rate and evaluate postoperative joint function among these groups.Results The statistical comparison,compared with internal fixation,arthroplasty in operation time and bleeding volume showed no significant difference,there was no statistically significant differcnce (P＞0.05); but during hospital stay,postoperative under load time and rate of complications were significantly better than those of the fixation group,the difference was statistically significaut(P＜0.05); postoperative joint function evaluation,the operation between the groups of the excellent and good rate were 90.0％,96.6％ and 100％ respectively,there was no significant difference (P＞0.05).Conclusion Joint replacement and DHS,PFN in the operation time,bleeding volume showed no significant difference,but after joint replacement,patients could have shorter hospital stay,less pain,rapid recovery,shortening the time of lying in bed,reducing the occurrence of complications.For the elderly femoral intertrochanteric comminuted fracture with serious osteoporosis,without closed reduction,and artificial femoral head arthroplasty,it is an effective choice when early ambulation not available with easy failure of internal fixation in intertrochanteric fractures. Key words: Artificial femoral head replacement; The elderly; Femoral intertrochanteric fracture; Comminuted fracture