Treatment with total hip arthroplasty for the failure of stable(3.1A1) femoral intertrochanteric fractures surgery using proximal femoral nail antirotation or dynamic hip screw

Abstract

Objective To investigate the clinical effect of total hip arthroplasty in the treatment of failure of femoral intertrochanteric fractures(3.1A1.1-3) with proximal femoral nail antirotaion or dynamic hip screw. Methods A retrospective study was performed on 192 patients(192 hips) underwent total hip arthroplasty(THA) to cure failed femoral intertrochanteric fractures surgery using proximal femoral nail antirotation or dynamic hip screw from January 2007 to April 2016.The preoperative and postoperative data,from the reasons for internal fixation failure,imaging changes,improved Harris score and postoperative complications were analyzed. Results The scores of Harris in each group were significantly higher than those before operation(P<0.05). There was no significant difference between the two groups.There were more postoperative complications in the DHS group compared with PFNA group,and the difference was statistically significant(P<0.05). Conclusion The total hip arthroplasty in the treatment of femoral intertrochanteric fractures with proximal femoral nail or dynamic hip screw failure has good clinical results.The postoperative complications are more likely to occur in patients with DHS for the first time,there is no significant difference between the two prostheses of bone cement and non-bone cement. Key words: Femoral intertrochanteric fracture; Total hip arthroplasty; Dynamic hip screw; Proximal femoral nail antirotaion