Abstract:

BACKGROUND: Using femoral head replacement for femoral neck fractures which shift significantly has become a consensus, but using artificial femoral head replacement for intertrochanteric fractures is controversial.
OBJECTIVE: To compare the effects and prognosis of artificial femoral head replacement for unstable intertrochanteric fractures and femoral neck fractures in elderly patients, and to evaluate the curative of unstable intertrochanteric fractures in elderly patients with the artificiall femoral head replacement.
METHODS: Totally 112 cases with artificial femoral head replacement for treating unstable intertrochanteric fractures and femoral neck fractures in elderly patients from June 2005 to June 2009 were selected. There were 52 cases in intertrochanteric fractures group, and 60 cases in femoral neck fractures group. Operation time, blood loss, time of post-surgery exercise, and hip function were compared.
RESULTS AND CONCLUSION: All the patients were followed-up for 12 to 39 months after replacement. Hip function was evaluated by Harris score which showed that the excellent and good rate was 92.1%, evaluation excellent for 22 cases, good for 25 cases, fair for 3 cases, and poor for 1 case in the intertrochanteric fractures group, but in the femoral neck fractures group, the excellent and good rate was 91.3%, evaluation excellent for 28 cases, good for 25 cases, fair for 4 cases, and poor for 1 case. Operation time (P < 0. 05) and blood loss (P < 0. 05) in the femoral neck fractures group were significantly lower than those in the intertrochanteric fractures group. There was no significant difference of the time of post-surgery exercise and excellent and good rate of efficacy in the two groups. It is indicated that artificial femoral head replacement can be used as the main method for the treatment of unstable intertrochanteric fractures in the elderly.