[HEMIARTHROPLASTY COMBINED WITH GREATER TROCHANTER REATTACHMENT DEVICE FOR TREATING INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS].

OBJECTIVE

To evaluate the effectiveness of hemiarthroplasty combined with greater trochanter reattachment device for intertrochanteric fractures in elderly patients.

METHODS

A retrospective analysis was made on the clinical data of 34 patients (35 hips) with intertrochanteric fractures underwent hemiarthroplasty combined with greater trochanter reattachment device between February 2010 and April 2013. Of 34 patients, 16 were males (16 hips) and 18 were females (19 hips), and the mean age was 85.6 years (range, 77-95 years). All fractures were caused by falling. The left hip was involved in 20 cases, the right hip in 13 cases, and the bilateral hips in 1 case. There were 33 cases (34 hips) of fresh fracture, and 1 case (1 hip) of old fracture. Fractures were rated as type III in 6 cases (6 hips), type IV in 11 cases (11 hips), and type V in 17 cases (18 hips) according to Evans-Jensen standard. All of the patients had different degree of osteoporosis and internal diseases.

RESULTS

All patients underwent surgery successfully. The operation time was 70-90 minutes (mean, 76.6 minutes); the intraoperative blood loss was 260-400 mL (mean, 301.5 mL); the postoperative drainage was 80-530 mL (mean, 290.6 mL); and the hospitalization time was 10-12 days (mean, 11.7 days). Postoperative infection of incision occurred in 1 case, which was cured after dressing; primary healing of incision was obtained in the other patients. No lower extremity deep vein thrombosis or other complications was observed. Twenty-six cases (27 hips) were followed up 12-48 months (mean, 21.3 months). X-ray examination showed fracture healing, and the healing time was 2.5-3.5 months (mean, 2.8 months). There was no dislocation, prosthesis loosening, dislocation, loosening of titanium cable, periprosthetic osteolysis, or other complications during the follow-up period. According to Harris hip score, the results were excellent in 8 hips, good in 15 hips, fair in 4 hips, and the excellent and good rate was 85.2% at 1 year after operation.

CONCLUSION

The hemiarthroplasty combined with greater trochanter reattachment device is a feasible and effective method to treat intertrochanteric fractures in the elderly patients. It can allow early ambulation and improve quality of life, but it is necessary to strictly control the indications, and perioperative management should be paid attention.