Comparison of clinical efficacy of femoral calcar prosthesis replacement and intramedullary nail in the treatment of elderly patients with intertrochanteric fracture

Zhongguo Gu Shang. 2020 Nov 25;33(11):1017-22. doi: 10.12200/j.issn.1003-0034.2020.11.006.


OBJECTIVE: To analyze the clinical efficacy of hip arthroplasty with femoral calcar prosthesis and proximal femoral nail fixation(PFNA) in the treatment of elderly patients(≥80 years old) with unstable intertrochanteric fractures(Evans Ⅲ, Ⅳ).

METHODS: From June 2016 to March 2018, 60 elderly patients with unstable intertrochanteric fractures treated with prosthetic replacement and PFNA were retrospectively analyzed. According to the surgical methods, they were divided into PFNA group and prosthesis group. In PFNA group there were including 21 males and 15 females, with an average age of(84.3± 2.9) years old;in the prosthetic group, there were 10 males and 14 females with an average age of (82.9±2.4) years old. The operation time, hemoglobin difference between preoperative and postoperative 1 day, postoperative ambulation time, hospitalization time and complications were observed and compared between the two groups. Harris hip score was performed 3 and 12 months after operation.

RESULTS: All patients were followed up for 12 to 24 months (19.3±4.8) months. One patient in the prosthesis group died of lung cancer one year later and the follow-up was terminated. The operation time of prosthetic group was longer than that of PFNA group(P<0.05);hemoglobin difference before and after operation had no difference between prosthetic group and PFNA group(P>0.05);the time of ambulation in prosthetic group was earlier than that in PFNA group(P<0.05); the number of complications in prosthetic group was less than that in PFNA group(P<0.05);there was no significant difference in Harris score between prosthetic group and PFNA group before treatment, but scores of both groups were significantly increased after treatment (P <0.05). After 3 months of follow-up, the score of prosthesis group was higher than that of intramedullary nail group(P<0.05), but there was no significant difference at 12 months after operation(P>0.05).

CONCLUSION: The elderly patients with intertrochanteric arthroplasty can reduce the burden of intertrochanteric arthroplasty and improve the quality of life.

PMID:33269850 | DOI:10.12200/j.issn.1003-0034.2020.11.006