Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (3): 362-367.doi: 10.3969/j.issn.2095-4344.2947

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Comparison of the standard and long-stem bone cement prosthesis replacement in the treatment of intertrochanteric fractures in elderly patients

Cheng Shigao1, 2, Wang Wanchun1, Jiang Dong2, Li Tengfei2, Li Xun2, Ren Lian2   

  1. 1The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; 2Loudi Central Hospital, Loudi 417000, Hunan Province, China
  • Received:2020-03-10 Revised:2020-03-16 Accepted:2020-04-18 Online:2021-01-28 Published:2020-11-16
  • Contact: Wang Wanchun, MD, Doctoral supervisor, Chief physician, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
  • About author:Cheng Shigao, MD, Master’s supervisor, Associate chief physician, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; Loudi Central Hospital, Loudi 417000, Hunan Province, China
  • Supported by:
    the Clinical Medical Technology Innovation Guidance Program in Hunan Province in 2017, No. 2017SK51203

Abstract: BACKGROUND: The choice of standard femoral prosthesis or lengthened femoral prosthesis for the treatment of femoral intertrochanteric fracture in the elderly with hemihip replacement has always troubled clinicians. 
OBJECTIVE: To compare the short-term clinical efficacy of standard and long-stem prosthesis replacement in the treatment of elderly comminuted intertrochanteric Jensen V fractures.
METHODS: Data of 216 elderly patients with comminuted intertrochanteric femoral Jensen V fractures undergoing bone cement artificial half hip arthroplasty in Loudi Central Hospital from January 2008 to January 2019 were retrospectively analyzed. According to the type of prosthesis, the patients were divided into standard stem prosthesis placement group (n=92) and long-stem prosthesis replacement group (n=124). According to the fracture situation, the wire Kirschner wire was used to reduce the trochanteric fracture. At 1 year after surgery, Hariss score of the hip joint was evaluated. X-ray examination was used to observe imaging manifestations around the prosthesis.
RESULTS AND CONCLUSION: (1) Two patients in the standard stem prosthesis placement group died; three patients in the long-stem prosthesis replacement group died. The remaining patients were followed up for 12-24 months. (2) At 1 year after surgery, Hariss scores were (88.6±2.9) in the standard stem prosthesis placement group with an excellent and good rate of 83.3%, and (86.9±2.7) in the long-stem prosthesis replacement group with an excellent and good rate of 82.6%; no significant difference was found between the two groups (P > 0.05). (3) In the standard stem prosthesis placement group, one case affected femoral greater trochanteric fracture nonunion; two cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. In the long-stem prosthesis replacement group, one case affected femoral greater trochanteric fracture nonunion; three cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. There was no significant difference in the incidence of complications between the two groups (P > 0.05). (4) It is indicated that the short-term clinical efficacy of standard and long-stem cement-type prosthesis replacement in the treatment of Jensen V type trochanteric fracture in elderly patients is satisfactory, with no statistical difference, but the long-term effect remains to be studied.

Key words: bone, femur, intertrochanteric fracture, old age, joint, replacement, cement type, prosthesis, fracture healing

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