Treatment Of Senile Intertrochanteric Fracture Research Articles

Retracted: Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care.

[This retracts the article DOI: 10.1155/2022/3556330.].

Study on the Efficacy and Safety of Combined Traditional Chinese and Western Medicine in the Treatment of Senile Intertrochanteric Fracture

Study on the Efficacy and Safety of Combined Traditional Chinese and Western Medicine in the Treatment of Senile Intertrochanteric Fracture

Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care.

In order to explore the clinical application value of intelligent health care knowledge combined with closed reduction intramedullary nail fixation in elderly patients with intertrochanteric fracture of the femur, a retrospective analysis is performed on 80 elderly patients who received intertrochanteric surgery from January 2019 to January 2021. All patients were divided into study group and control group based on intelligent medical knowledge received or not. During the phase of treatment, both the two groups were treated with closed reduction and intramedullary nailing. The control group received conventional knowledge training and rehabilitation before and after the surgery, and the research group received additional intelligent medical knowledge health care. Observations of patients after bed and ground time are compared and the VAS score is used to evaluate the pain degree at 12 h, 24 h, and 48 h after surgery. Besides, the incidence of postoperative complications in the two groups is observed. From the clinical follow-up results, it is clearly evident that intramedullary nail fixation based on medical care knowledge can effectively improve the hip function and quality of life in patients, reduce postoperative pain, and improve the prognosis of elderly patients with femoral trochanteric fracture.

Evaluation of the clinical efficacy of 3D Printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in the treatment of Senile Intertrochanteric Fractures.

Objectives:To observe the clinical value of 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in elderly patients with intertrochanteric fractures.Methods:Sixty elderly patients with intertrochanteric fractures of the femur who were treated in our hospital from January 2018 to January 2020 were selected and randomly divided into two groups. In the experimental group, 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation was used for treatment. While in the control group, traditional open reduction and dynamic hip screw internal fixation combined with postoperative conventional treatment was utilized. The duration of surgery, intraoperative blood loss, postoperative hospital stay, weight bearing time, fracture healing time and other surgical indicators were recorded respectively, and hip joint function recovery was evaluated prior to and 2 weeks after surgery. All patients were followed up for six months to observe the occurrence of complications within half a year, including deep vein thrombosis, incision infection, avascular necrosis of femoral head, hip joint stiffness, delayed fracture healing, etc. Subsequently, the differences in postoperative complications between the two groups were compared and analyzed.Results:The operation time, blood loss, postoperative hospital stay, weight bearing time and fracture healing time of the experimental group were better than those of the control group, and the difference was statistically significant (p<0.05). After treatment, the hip joint function of the experimental group was significantly improved compared with the control group, with a statistically significant difference(p=0.03). The incidence of operative complications in the experimental group was 10% (3/30) within six months postoperatively, significantly lower than the 33% (10/30) in the control group, with statistical significance (p=0.03).Conclusion:3D printing with early rehab proved to be effective treatment in our study. Such a combined treatment has the advantages of precise operative reduction, fast postoperative recovery, and certain safety and effectiveness.

Analysis of influencing factors of failure of internal fixation after closed reduction and internal fixation for intertrochanteric fractures in the elderly

Objective To explore the process of clinical treatment of senile intertrochanteric fractures in patients with closed reduction and internal fixation, to analyze the related factors leading to operation failure, and to lay the foundation for the clinical treatment in Department of Orthopedics. Methods 100 elderly patients with intertrochanteric fracture were treated with closed reduction and internal fixation, and the related factors leading to the failure of the operation were analyzed. Results Through the statistics of all patients, 7 cases were found in patients with internal fixation failure.The internal fixation failure rates of the patients with 4~6 class Singh index, basic diseases, TAD>25mm, and the using of hormone drugs were significantly higher than those of the patients with 1-3 class Singh index, basic diseases, TAD≤25mm, and no using hormone drugs, the differences were statistically significant(χ2=6.246, 4.532, 4.532, 6.439, all P 25mm and Cleveland partition were internal fixation failure risk factors, the difference was statistically significant(all P<0.05). Conclusion In the application of closed reduction and internal fixation for the treatment of intertrochanteric fractures in the elderly patients, the fracture type, Singh index, basic disease, TAD>25mm and Cleveland partition can be used as the risk factors of internal fixation failure. Key words: Intertrochanteric fractures; Fracture fixation, internal; Internal fixation failure; Influencing factors

Analysis of mid-term efficacy of biological type long-stem artificial caput femoris replacement operation in the treatment of unstable senile intertrochanteric fracture

Objective To explore the mid- term efficacy of biological type, long- stem artificial caput femoris replacement operation in the treatment of unstable senile intertrochanteric fracture. Methods 73 patients accepted the treatment of biological type long- stem artificial caput femoris replacement operation, and 64 cases were followed. After 3 months of operation,these 64 patients were divided into four groups which marked as A,B,C and D according to the Berg balance scale(BBS). Accordingly,54 patients that in grade A,B and C would be brought into in long- term follow- up study.54 cases include 25 male patients and 29 female patients with an average age of 81.6 years old who aged from 73 to 94 years old.According to Evans- Jensen classification,28 cases were Evans- Jensen Ⅱ and the left 26 cases were Evans- Jensen Ⅲ. Results The follow-up period was in the range of 24 to78 months(mean 42months). During this period, except the 9 death cases, there was no case of femoral trochanteric ununited fracture, femoral prostheses loosening or dislocation of hip joint. In total,3 cases occurred with loss of fixing wire,4 cases occurred with acetabular wear, one case was experienced prosthesis adjacent fracture and three cases of heterotopic ossification. According to the Engh standard, all femoral prostheses got osseous fixation. The rate of excellent and good result were 88.9% with in which excellent in 23 cases and good in 17 cases. Conclusion The application of biological type long-stem artificial caput femoris replacement in the treatment of unstable senile intertrochanteric fracture can achieve satisfactory midterm efficiency. Key words: Femoral Fracture; Arthroplasty, Replacement, Hip; Aged

Analysis of failure after treatment of senile femoral intertrochanteric fractures with InterTan nails

Objective To analyze the causes for failed treatment of senile patients with femoral intertrochanteric fracture by the InterTan nailing system.Methods We retrospectively analyzed the clinical data of 337 elderly patients who had been treated in our department from April 2009 to December 2012 for femoral intertrochanteric fracture with closed reduction and internal fixation with InterTan nails.They were 189 males and 148 females,60 to 87 years of age (mean,69.7 years).According to the AO/OTA classification,71 fractures were type A1.1,89 type A1.2,78 type A1.3,51 type A2.1,35 type A2.2,7 type A2.3,and 6 type A3.We observed intraoperative and postoperative complications to analyze the causes for failed internal fixation and their preventive countermeasures.Results Of all the patients,205 were followed up for an average of 2.3 years (from 0.5 to 4.0 years).The rate of follow-up was 60.8％ (205/337).The fracture healed in 169 out of 205 patients after 2.6 to 3.4 months (average,2.9 months).Twelve months after operation,14 patients died and fixation failure occurred in another 22 patients (10.7％).Varus deformity was found 3 months postoperatively in 6 cases,of which 4 were complicated with cutout of a lag screw.At 6 months postoperatively,shortening of the femoral neck was found in 2 cases and varus deformity in 11 cases.After the intertrochanteric fracture healed during follow-up,3 cases of femoral fractures occurred at the end of the nail.We performed revision surgery for all these 22 cases of failed fixation.Arthroplasty was done for 5 cases and fixation was changed for 17 cases.After the revision surgery,fracture healed in 12 cases and 5 cases died within 12 months postoperatively.Conclusions The senile femoral intertrochanteric fractures can be successfully treated by the InterTan nailing system,but intraoperative and postoperative complications are inevitable.Good intraoperative manipulation is the key to preventing failure of the fixation and intensive postoperative follow-up is needed to watch out for complications like varus deformity,shortening of the femoral neck and cutout of a lag screw. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails; Old

Clinical effects and helical blade positions in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation

Objective To compare the clinical effects of 2 common installation positions of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods From January 2010 to December 2012,166 old patients with intertrochanteric fracture were treated by PFNA.According to the installation position of the helical blade in the femoral head on the postoperative X-ray films,they were divided into a C/C group (87 cases) where the helical blade was at the center of the femoral head in both anteroposterior and lateral views and an I/C group (79 cases) where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of reduction quality,tip-apex distance (TAD),full weight bearing time,fracture healing time,and Harris Hip Score(HHS) at the last follow-up.Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months.There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94.0％ (78/83) versus 94.7％ (72/76)],full weight bearing time (9.4 ± 1.5 weeks versus 9.3 ± 1.3 weeks),fracture healing time (17.8 ±2.3 weeks versus 17.2 ±2.3 weeks),or HHS (89.6 ±4.6 points versus 89.3 ±4.7 points) (P ＞ 0.05).There was a significant difference in TAD (21.14 ± 3.17 mm versus 24.96 ± 3.48 mm) between the 2 groups(t =-7.242,P =0.000).No infection or cut-out or other related complications of the helical blade occurred in either group.Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails; Helical blade

Preliminary effect of proximal femoral nail antirotation on emergency treatment of senile patients with inter-trochanteric fracture

Objective To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). Methods From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type I fractures, 19 type II and 6 type III according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade I, 14 grade II, 8 grade III, and 4 grade IV. Results The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2–4 days after operation (mean 3.5 days). Hospital stay was 4–7 days (mean 5.3 days). Full weight bearing time was 10–14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15–18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had trochanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. Conclusion The emergency treatment of senile inter-trochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of stay, less complications, and the preliminary clinical effect is satisfactory.

Use small incision in artificial femur head replacement in the treatment of senile intertrochanteric fracture

目的 分析和评价小切口人工股骨头置换治疗高龄老年人粗隆间骨折的可行性和疗效.方法应用小切口人工股骨头置换治疗79～98岁高龄老年人粗隆间骨折18例,男6例,女12例,平均86岁.骨折类型:Ⅲ型6例,Ⅳ型8例,Ⅴ型4例.结果 18例均获随访,时间3～19个月,元一例死亡,关节功能良好.术后6～21 d下地扶助行器辅助行走,平均时间为7 d.以髋关节活动度、疼痛程度及生活自理情况为观察指标,优良率为91%,未出现假体松动、下沉等现象.结论小切口人工股骨头置换治疗高龄老年人粗隆间骨折创伤相对较小,疗效满意。

Anatomical plate in treatment of senile intertrochanteric fractures

目的 探讨解剖型钢板治疗老年股骨转子间骨折的临床疗效.方法2001年1月～2003年12月使用德国Link公司生产的解剖型钢板治疗老年股骨转子间闭合骨折35例,AO分型A1型11例、A2型17例、A3型7例,对手术情况、疗效进行回顾性分析总结.结果35例患者中,优31例,良2例,差2例,优良率94.2%.运用解剖型钢板治疗股骨转子间骨折取得良好的临床效果.结论解剖型钢板治疗时创伤小,手术灵活,易取得成功,适用于老年股骨转子间骨折的治疗。