Effects of hemiarthroplasty with different hip prostheses on prognosis of unstable osteoporotic intertrochanteric fractures in elderly patients / 中华创伤杂志

ABSTRACT

Objective To investigate the effects of hemiarthroplasty with different hip prostheses on the prognosis of unstable osteoporotic intertrochanteric fractures in elderly patients.Methods A retrospective case series study was conducted on the clinical data of 556 elderly patients with unstable osteoporotic femoral intertrochanteric fractures treated with hemiarthroplasty from January 2008 to December 2014.There were 142 males and 414 females,aged (83.1 ± 6.9) years (range,75-103 years).The T value of bone mineral density was-3.5--2.5 SD [(-2.8 ± 0.2) SD].There were 306 cases of type A2.2 and 250 cases of type A2.3 according to AO classification.There were 296 cases of cement type and 260 biological type according to prosthesis type.Operation time,blood loss,time for ambulation,Harris hip score,and incidence of perioperative major complications were used to compare the therapeutic outcomes between the two types of prostheses.Results The operation time [(75.5 ±9.2) minutes],blood loss [(992.9 ± 94.2)ml],and time for ambulation[(7.1 ± 1.8) days] in cement type group were all less than those [(86.1 ± 9.3) minutes,(1 139.5 ± 96.0) ml,and (8.6 ± 2.1) days]in biological type group,but the lung infection rate (19.9％),incidence of cardio-cerebrovascular complications (15.9％) and total death rate (7.1％) in cement type group were significantly greater than the those (13.5％,8.8％ and 1.9％) in biological type group (P ＜ 0.05).There was nosignificant difference in Harris score (73.6％ vs.82.7％) between the two groups (P ＞ 0.05).Conclusions In the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients by hemiarthroplasty,the use of cement type prosthesis can reduce operation time,blood loss and bed rest time,but it will lead to significant increases of cardio-cerebrovascular complication and overall mortality.The prosthesis type has no significant effect on the improvement of hip function.