Objective To research the feasibility and clinical effect of artificial hip replacement in the treatment of the femoral head osteonecrosis combined with ipsilateral femoral intertrochanteric fractures.Methods A retrospective analysis was per-formed on 18 patients with avascular necrosis of femoral head combined with ipsilateral femoral intertrochanteric fractures from October 2019 to March 2021.One-stage artificial hip replacement combined with fracture reduction and internal fixation was performed with the biologically lengthened stem.The Harris score of hip function was compared preoperatively and at the final follow-up,and complications were recorded during the follow-up.Fracture-healing was evaluated according to the clinical frac-ture-healing criteria.Clinical efficacy was assessed according to the Harris score of hip function.Results All the 18 cases were followed up for 20 to 36 months(mean,32.0 months).The incision dressing changes were on time,the incisions healed and stitches were taken out in one stage,and there were no complications such as cardiovascular and cerebrovascular diseases in perioperative period.All fractures reached clinical healing with the healing time of(3-6)months,and the average of 5.0 months.There were no complications such as infection,prosthesis loosening and dislocation,periprosthesis fracture,and deep venous thrombosis of lower limbs during follow-up.All patients could walk independently without assistance at the final follow-up.The Harris score of hip function at the final follow-up was(86.89±4.64),which was significantly higher than that before operation(53.11±3.45),and the difference was statistically significant(P＜0.05).At the final follow-up,the clinical efficacy was excellent in 10 cases,good in 6 cases,fair in 2 cases,and the excellent and good rate was 88.9％.Conclusion One-stage hip arthroplas-ty combined with fracture reduction and internal fixation in the treatment of avascular necrosis of femoral head combined with ipsilateral femoral intertrochanteric fractures is clinically feasible and effective.It is recommended to choose the biological full-coated extended femoral stem prosthesis,which has good initial stability and fracture fixation.
Osteonecrosis of the femoral headIntertrochanteric fractureArtificial hip replacementInternal fixation
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