Clinical efficacy analysis of lengthened stem artificial femoral head replacement combined with personalized internal fixation in treatment of unstable femoral intertrochanteric fractures in elderly patients
Objective To observe the clinical efficacy of cemented extended stem artificial femoral head replacement combined with personalized internal fixation in the treatment of unstable femoral intertrochanteric fractures in the elderly.Methods A ret-rospective analysis of 82 cases of unstable femoral intertrochanteric fractures in the elderly treated with cemented extended stem artificial femoral head replacement from July 2018 to July 2021 was conducted.During the operation,the affected hip joint was slightly mobilized after the bone cement solidified.The personalized fixation was performed depending on whether the femoral greater trochanter and femoral calcar mass were displaced after activation.If only the femoral greater trochanter was displaced,the comminuted fracture was treated,and the femoral greater trochanter was fixed with tension band,steel wire or titanium ca-ble.If only the femoral calcar block was displaced,the greater trochanter and femoral calcar was tied with steel wire or titanium cable,and the steel wire or titanium cable was tightened to fix it.If both femoral greater trochanter and femoral calcar were dis-placed,the femoral greater trochanter was fixed with tension band,steel wire or titanium cable,and then femoral greater trochan-ter and femoral calcar were fixed with steel wire or titanium cable.Results Two cases died due to aggravation of underlying diseases after operation,and the remaining 80 cases were completely followed up for 6-18 months,with an average of 13.5 months.Seven cases had respiratory system infection after operation,and they were cured after anti-infection,phlegm reduction,turning over and patting the back.Four cases had non-union of femoral trochanter fracture,but the walking function was normal,and no special treatment was given.The incision fat liquefaction occurred in 2 cases,and the incision healed well after dressing change.One case had postoperative trauma caused the separation and displacement of femoral trochanter fracture,and the frac-ture healed after re-operation and re-binding and fixation.At the last follow-up visit,hip X-ray film showed that the artificial femoral head prosthesis was in place,the bone cement was well filled,and all the femoral trochanteric fractures healed.At the last follow-up,the Harris score of hip function ranged from 75 to 92,with an average of 89.2.Conclusion The treatment of un-stable femoral intertrochanteric fractures in the elderly with cemented extended stem artificial femoral head replacement can re-duce the incidence of bed-rest complications and avoid the risk of internal fixation failure of fractures.The combination of femo-ral greater trochanter and femoral calcar mass personalized internal fixation can provide good stability for femoral prosthesis and promote the recovery of hip joint function.
Unstable femoral intertrochanteric fractureArtificial femoral head replacementBone cement type lengthened stemFemoral calcarPersonalized internal fixationAdvanced age
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