Short-term efficacy of hollow screw bandage combined with hemiarthroplasty for elderly intertrochanteric fractures

Abstract

Objective The main purpose of this study is to investigate the short-term effect of hollow screw banding combined with hemiarthroplasty in the treatment of intertrochanteric fracture in the elderly. Methods From August 1, 2015 to August 1, 2017, patients with intertrochanteric fracture of femur in the People's Hospital of Xinjiang Autonomous Region were selected, especially those with serious destruction of the lateral wall of femur. All operations were performed through the posterolateral approach. Double-acting femoral head replacement combined with hollow snail were used during the operation. C-reactive protein, erythrocyte sedimentation rate, blood routine and X-ray films were reviewed on the first day, 1, 3, 6 months and 1 year after operation. Bone healing, loosening of bandage and hollow screw, loosening and subsidence of femoral stem prosthesis were observed on X-ray films. The hip function was evaluated by Harris hip score (HHS), Assessment of joint activity (TUG). Results One year after operation, 15 cases of trochanteric fracture showed bone healing, no loosening of hollow screw and binding band, stable long handle of bone cement, no obvious loosening and sinking, normal C-reactive protein, erythrocyte sedimentation rate and blood routine, no redness and swelling in wound area, no signs of infection. Harris score: The HS score at the last follow-up was (76+17). The TUG score at the last follow-up was (17+9) seconds. Mild pain occurred after lateral movement of greater trochanter after operation, and 2 cases could be relieved by rest. At the last follow-up, the abductor strength of gluteus medius reached grade 5 in 5 cases, grade 4 in 4 cases, and grade 3 in 3 cases. There were 3 cases of residual mild lameness, all of which were grade 3 (2 cases) of gluteal abductor strength. One case was unsatisfied with the effect of operation, limping (1 case), and the other 14 cases were very satisfied or satisfied. All patients walked within 3 days after operation. Conclusion The treatment of intertrochanteric fracture of femur in elderly patients with femoral head replacement combined with hollow screw and bandage reconstruction can obtain early initial stability, help patients get out of bed early, and have a good short-term effect, which significantly improves the quality of life of patients. Key words: Hip fractures; Aged; Bone screws; Hemiarthroplasty; Cerclage band