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.
ABSTRACT
BACKGROUND: Many studies have suggested that artificial joint replacement has a greater advantage in the treatment of cases of elderly osteoporosis, comminuted fractures and unable to internal fixation or failure of internal fixation. OBJECTIVE:To analyze the curative effect of cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture. METHODS: Totaly 18 patients with unstable intertrochanteric fracture, aged>75 years, were enroled and underwent cemented artificial femoral head arthroplasty. At 3 months after replacement, the curative effect was evaluated according to the Harris hip joint function score method. The early complications after replacement and long-term complications of prosthesis were observed by folow-up. RESULTS AND CONCLUSION:Al these 18 patients were folowed up for 13 to 34 months, and had no infections, pressure sores, femoral shaft fractures and other complications. X-ray films showed that the frauture healed wel, without prosthesis infection, dislocation, loosening, sinking and breaking. After 3 months of replacement, al patients returned to pre-injury level of walking function. The curative effect was excelent for eight cases, good for seven cases, fair for two cases, poor for one case. These results demonstrate that cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture has good biocompatibility and stability, and can restore the limb function of patients.