Abstract:

BACKGROUND: In recent years artificial joint replacement surgery has become a new method for the treatment of intertrochanteric fractures of the elderly. In the traditional treatment of internal fixation of senile intertrochanteric fractures, the prosthesis is implanted following fracture treatment, or the small trochanter is treated and the prosthesis is implanted, followed by greater trochanter treatment. It remains controversial about the application of lengthened or standard length stem.
OBJECTIVE: To evaluate the effect of artificial joint replacement on elderly patients with unstable intertrochanteric fracture, and observe the influence of the order of prosthesis implantation, small trochanter and greater trochanter treatment during the surgery.
METHODS: The clinical data of 28 elderly patients with unstable femoral intertrochanteric fractures treated in Department of Orthopedics, the 451 Hospital of Chinese PLA from January 2006 to December 2008 were retrospectively analyzed, including 20 undergoing artificial joint replacement and 8 undergoing total hip replacement with cemented prosthesis. X-ray, Harris scores of hip joint and complications were observed postoperatively.
RESULTS AND CONCLUSION: All patients were followed up for 1 to 4 years (average 2.8 years), with an excellent and good rate of 89.3%. No coxa vara, infection, loosening or dislocation was found. The surgery can quickly restore limb function and reduce complications. The treatment of greater and small tuberosity fracture and prosthesis is very important. The prosthesis is firstly implanted, followed by internal fixation with the prosthesis as the support. Tightly matching of the proximal femur and prosthesis is essential for the stability of postoperative prosthesis, and lengthened or standard length stem can be used.