Different reconstruction methods of proximal femur in cementless long-stem hip arthroplasty for unstable femoral intertrochanteric fractures in older adults: a comparative study

doi:10.3969/j.issn.2095-4344.1120

Abstract

Abstract:

BACKGROUND: Treatment of unstable intertrochanteric fractures in the elderly by cementless long-stem hip arthroplasty requires the reconstruction of the important structure of proximal femur, but the reconstruction methods remain controversial.

OBJECTIVE: To compare the clinical efficacy of proximal femur reconstruction using different methods in cementless long-stem hip arthroplasty for senile unstable femoral intertrochanteric fractures.

METHODS: A retrospective study of 52 older adults with unstable femoral intertrochanteric fractures undergoing cementless long-stem hip arthroplasty at Chongqing Orthopedic Hospital of Traditional Chinese Medicine from March 2015 to April 2017 was conducted. All patients belonged to types III, IV, and V according to Evans classification, and bone mineral density of lumbar spine T value was less than -2.5. The patients were divided into groups A (n=25, fixed by Kirschner wire and tension band wearing) and B (n=27, fixed by steel wire and non-absorbable suture). The operation duration, intraoperative blood loss, incision length, independent weight-bearing time, postoperative complications and Harris scores at 1, 3, 6 and 12 months postoperatively were compared.

RESULTS AND CONCLUSION: (1) The operation time and intraoperative blood loss in the group A were significantly higher than those in the group B (P < 0.01). (2) There was no significant difference in the incision length or postoperative independent weight-bearing time between two groups (P > 0.05). (3) The incidence of postoperative complications in the group A was significantly higher than that in the group B (P < 0.05). (4) The Harris hip scores at 1, 3, 6 and 12 months showed no significant differences between two groups (P > 0.05). (5) In summary, steel wire and non-absorbable suture applied in the cementless long-stem hip arthroplasty for senile unstable femoral intertrochanteric fractures can significantly shorten the operation time, reduce intraoperative blood loss and decrease the postoperative complications.

Key words: Femoral Fractures, Arthroplasty, Replacement, Hip, Tissue Engineering

CLC Number:

R459.9

Deng Yu, Xia Yuxin, Bai Xinwen, Qi Wei. Different reconstruction methods of proximal femur in cementless long-stem hip arthroplasty for unstable femoral intertrochanteric fractures in older adults: a comparative study[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(12): 1805-1811.

Figures/Tables 5

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