Comparative analysis of efficacy of different treatments for osteoporotic femoral intertrochanteric fractures in the elderly / 中华创伤杂志

ABSTRACT

ObjectiveTo compare the outcomes of total hip replacement (THR) and minimally invasive dynamic hip screw (MIDHS) in treating osteoporotic femoral intertrochanteric fractures so as to discuss the differences of the two treatment methods.Methods A retrospective study was done on 48 elderly patients with femoral intertrochanteric fractures.All the patients were randomly treated with THR (THR group) and MIDHS internal fixation ( MIDHS group).After a follow-up of over six months,the two groups were compared concerning the operation time,intraoperative blood loss,postoperative drainage,postoperative hip function,and postoperative complications.ResultsTHR group had longer operation time,larger volume of intraoperative bleeding and postoperative drainage as compared with the MIDHS group.The incidence of internal fixation loosening varied significantly with different degree of osteoporosis in the MIDHS group,but not in the THR group.The loosening rate of the implants in the MIDHS and THR groups was 33.3％ and 4.1％ respectively,with significant difference.Functional evaluation of hip showed no significant differences between the two groups six months postoperatively.ConclusionFor achieving earlier and better functional recovery and less postoperative complications in the management of osteoporotic femoral intertrochanteric fractures,MIDHS can be considerel for the elderly patients with low degree of osteoporosis and THR for younger patients with high degree of osteoporosis.