Hemiarthroplasty treats intertrochanteric fractures and femoral neck fractures in the elderly: comparison of follow-up

doi:10.3969/j.issn.2095-4344.2014.53.008

Abstract

Abstract:

BACKGROUND: Hemiarthroplasty is the preferred therapeutic regimen for displaced femoral neck fractures in the elderly patients, but whether it can be applied as the primary treatment of intertrochanteric fractures remains controversial.
OBJECTIVE: To compare the efficacy of hemiarthroplasty in treatment of intertrochanteric fracture and femoral neck fractures in the elderly patients, and evaluate the application value of hemiarthroplasty in treatment of intertrochanteric fractures in the elderly patients.
METHODS: Ninety elderly patients with hip fracture were included in this study, at the age of ≥ 80 years old. There were 35 cases in intertrochanteric fracture group and 55 cases in femoral neck fracture group. All involved patients were treated with cemented hemiarthroplasty and followed up for 1-5 years. The time of replacement procedure, intraoperative blood loss, weight-bearing time after replacement, complications, Harris score were compared and analyzed in the two groups.
RESULTS AND CONCLUSION: The average follow-up time was 2.8 years in the two groups. There was no significant difference in the hip joint space, pain, and loosening of the prosthesis handle between the two groups (P > 0.05). The prosthesis revision rate, intraoperative blood loss, weight-bearing time after replacement, and Harris score showed no significant difference in the two groups (P > 0.05). The time of replacement procedure in the intertrochanteric fracture group was significantly longer than that in the femoral neck fracture group (P < 0.01). Experimental findings indicate that, hemiarthroplasty has equal effect in treatment of unstable intertrochanteric fractures and femoral neck fractures in the elderly patients.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: femoral neck fracture, hip fracture, hip prosthesis, age

CLC Number:

R318

Zhang Shou, Kong Chang-geng, Xing Shi, Jin Xu-hong, Wang He-jie, Ding Xiao-li. Hemiarthroplasty treats intertrochanteric fractures and femoral neck fractures in the elderly: comparison of follow-up[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8570-8574.

Figures/Tables 1

General information of the involved patients There was no significant difference in the age, medical illness and injury cause between the two groups, general information of the involved patients were comparable (P > 0.05; Table 1). Comparison of operative time, intraoperative blood loss, time of weight loading postoperatively and Harris scores All involved patients completed the surgery successfully. There was no significant difference in the intraoperative blood loss, time of weight loading postoperatively and Harris scores at the last follow-up (P > 0.05). The operation time in intertrochanteric fracture group was significantly longer than that in femoral neck fracture group (P < 0.01; Table 2). Comparison of complications in the two groups Seven cases (20%) in intertrochanteric fracture group had complications, including two cases of pulmonary infection, one case of urinary tract infection, one case of deep vein thrombosis, and three cases of cardiovascular disease (heart failure, cerebral infarction). Ten cases (18%) in femoral neck fracture group had complications, including two cases of pulmonary infection, three cases of urinary tract infection, two cases of deep vein thrombosis, and three cases of cardiovascular disease (heart failure, infarction). No cases in the two groups appeared pressure sores and incisional infection, there was no significant difference in the complication rate between the two groups (P > 0.05). Comparison of biocompatibility and adverse reactions in the two groups In the intertrochanteric fracture group, two cases appeared hip joint space changes and pain, two cases appeared prosthesis loosening, and one case received prosthesis revision. In the femoral neck fracture group, four cases appeared hip joint space changes and pain, one case appeared prosthesis loosening, and one case received prosthesis revision. The host response and prosthesis revision rate showed no significant difference between the two groups (P > 0.05)."

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