Comparison of three implants for treating intertrochanteric fractures of cerebral infarction hemiplegia side in older adults

doi:10.3969/j.issn.2095-4344.1178

Abstract

Abstract:

BACKGROUND: Proximal femoral nail anti-rotation and the locking compression plate are common methods for treating intertrochanteric fractures in the elderly. At the same time, some scholars believe that the cemented hemiarthroplasty can achieve good curative effect. However, there are still many controversies in the surgical treatment of intertrochanteric fractures of cerebral infarction hemiplegia side in the elderly.

OBJECTIVE: To compare the clinical efficacy of cemented hemiarthroplasty, proximal femoral nail anti-rotation and locking compression plate for senile intertrochanteric fractures of cerebral infarction hemiplegia side.

METHODS: Ninety-six patients with senile intertrochanteric fractures of cerebral infarction hemiplegia side at Affiliated Hospital of Chengde Medical University and the Third Hospital of Hebei Medical University from June 2010 to January 2017 were enrolled. There were 38 males and 58 females, aged ≥ 65 years, 29 patients were treated with cemented hemiarthroplasty, 32 patients were treated with proximal femoral nail anti-rotation, and 35 patients were treated with proximal femoral locking compression plate. The operation time, intraoperative blood loss, hemoglobin difference before and after surgery, postoperative bed rest time, postoperative complication rate and hip Harris scores at 6 and 12 months postoperatively were compared among groups.

RESULTS AND CONCLUSION: (1) The operation time in the anti-rotation intramedullary nail group was shorter than that in the cemented hemiarthroplasty and locking compression plate groups (P < 0.05). The intraoperative blood loss in the cemented hemiarthroplasty group was more than that in the anti-rotation intramedullary nail and the locking compression plate groups (P < 0.05). The anti-rotation intramedullary nail group had longer bed rest time than the cemented hemiarthroplasty and the locking compression plate groups (P < 0.05), and the difference of hemoglobin before and after surgery was lower than that in the cemented hemiarthroplasty and locking compression plate groups (P < 0.05). (2) There was no difference in the incidence of complications among groups (P > 0.05). (3) The Harris score at 6 months postoperatively in the cemented hemiarthroplasty group was higher than that in the anti-rotation intramedullary nail and the locking compression plate group (P < 0.05). The Harris score at 12 months postoperatively in the cemented hemiarthroplasty and the anti-rotation intramedullary nail groups was higher than that in the locked compression plate group (P < 0.05). (4) These results suggest that compared with the locking compression plate, the cemented hemiarthroplasty and anti-rotation intramedullary nail for treating senile intertrochanteric fractures of cerebral infarction hemiplegia side, can shorten postoperative bed rest time, and good postoperative hip function recovery, can be used as a priority. Arthroplasty due to intraoperative bleeding, surgical risk is relatively increased, so individualized assessment and treatment are required.

Key words:

intertrochanteric fractures, cerebral infarction, hemiplegia, artificial femoral head replacement, proximal femoral anti-rotation intramedullary nail, proximal femoral locking compression plate

CLC Number:

R459.9

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R459.9

Zhang Qingzhu, Fan Qi, Yin Xuelian, Wang Pengcheng, Hou Jing, Feng Zhen, Shi Litao, Zhang Zhongyan, Li Aihua, Wan Qian .

Comparison of three implants for treating intertrochanteric fractures of cerebral infarction hemiplegia side in older adults

[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(24): 3805-3811.

Figures/Tables 5

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