A comparative study on hemiarthroplasty and dynamic hip screw treating femoral intertrochanteric fractures in the old patients
WANG Chang-xing, JIANG Tao, SHEN Jian-guo, CAO Gen-hong, WU Jian-min, SHOU Yue-peng
Published 2009-05-15
Cite as Chin J Trauma, 2009,25(05): 418-421. DOI: 10.3760/cma.j.issn.1001-8050.2009.05.129
Abstract
Objective To compare the clinical effects of hemiarthroplasty and dynamic hip screw (DHS) in treatment of unstable femoral intertrechanterie fractures in the elderly. Methods A total of 62 elderly patients with unstable femoral intertrochanteric fractures treated from January 2004 to April 2007 were randomly divided into DHS group and hemiarthroplasty group, with 31 patients in each group. The patients were foLlowed up to compare the clinical effects between two groups. Results Of all, 58 patients ( including 28 patients in the hemiarthroplasty group and 30 in DHS group) were followed up for 13-49 months. The mean operation time was ( 76.07 ± 6.29 ) minutes in hemiarthroplasty group and ( 117.50 ± 8.88 ) minutes in DHS group ( P < 0.05 ). The mean blood loss during operation was (305.36±34.26) ml in hemiarthroplasty group and (431.67±53.31) ml in DSH group (P<0.05). The postoperative complications occurred in three patients in hemiarthroplasty group and 10 in DHS group, with statistical difference ( P < 0. 05 ). The Harris score for hip function was ( 85.46 ± 3.05 ) points in hemiarthroplnsty group and ( 79.73 ± 2.57 ) points in DHS group, with no statistical difference between two groups ( P > 0.05 ). Conclusions DSH is still one of effective methods for patients with unstable femoral intertrochanterie fractures. Hemiarthroplasty can diminish bleeding during operation, help walk earlier and reduce complications and is a better selection for the elderly patients with osteoporosis and unstable femoral intertrochanteric fractures. However, hemiarthroplasty can not replace DHS.
Key words:
Arthroplasty, replacement; Fracture fixation, internal; Hip fractures; Osteoporosis
Contributor Information
WANG Chang-xing
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China
JIANG Tao
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China
SHEN Jian-guo
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China
CAO Gen-hong
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China
WU Jian-min
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China
SHOU Yue-peng
Department of Orthopedics,Second Affiliated Hospital,Traditional Chinese Medicine University of Zhejiang ,Hangzhou 310005,China