ABSTRACT
Objective: The treatment methods for the failed internal fixation in elderly patients suffering from several osteoporostic fractures are still inconclusive. We aimed to evaluate the clinical effects of endoprosthetic replacement for failure treatment of intertrochanteric fracture
Methodology: A total of 13 patients with failed internal fixation for intertrochanteric fracture were collected between January 2002 and October 2009. All of them were treated with endoprosthetic replacement and followed up till October 2010. Four of them received total hip replacement and the remained nine received artificial bipolar femoral head replacement. Clinical and functional outcomes of patients were assessed
Results: Of 13 patients, nine were females and four were males with the mean age of 76.5 years [SD, 11.7, range, 58-92 years] at the time of fracture. The average time of operation and follow-up was 124 minutes [89-187minutes] and 31 months [14-68 months], respectively. The average blood loss during the operation was 631 ml [450-1560 ml]. All patients showed good pain relief and functional improvement. Final postoperative Harris and WOMAC scores were significantly improved from pre-operative levels [P < 0.05]. Only five patients showed operative complications
Conclusions: Our finding indicated that endoprosthetic replacement is an effective salvage procedure for failed internal fixation of intertrochanteric fracture in elderly patients with effective pain relief and functional improvement as well as few serious complications
ABSTRACT
OBJECTIVE@#To compare the effect of surgical intervention on functional treatment.@*METHODS@#By searching the MEDLINE (1966 to October 2011), EMBASE (1980 to October 2011), the Chinese Biomedical Database Databases (1980 to October 2011), a total of 9 related RCT studies comparing surgical intervention with functional treatment were included in our study. RevMan software was taken to analyze the data.@*RESULTS@#These 9 studies involved a total of 1 268 mostly young adults, including 580 patients with surgical treatment and 688 patients with functional treatment. The results showed the stability of ankle activity in surgical treatment group was better than that in functional treatment group, with the OR and 95% CI of 0.72 (0.52-0.99). No significant difference was found in the recurrence of the surgical and functional group. However, the movement disorder in the surgical treatment suggested increased risk than that in functional group, with the OR and 95% CI of 2.39 (0.98-5.85). Surgical group found more complication than the function group, such as deep vein thrombosis, deep venous thrombosis, tenderness of scar and sensory loss.@*CONCLUSIONS@#In conclusion, our finding showed that surgical treatment could gain better efficacy than functional treatment, but may bring more complication. Therefore, further large sample size RCT is warranted.