Clinical application analysis of two internal fixation methods in artificial femoral head replacement for intertrochanteric fractures in the elderly
Objective To evaluate the clinical effect of two different internal fixation methods in elderly patients in artificial femoral head replacement for intertrochanteric fracture in elderly patients.Methods A to-tal of 100 elderly patients with intertrochanteric fractures who underwent artificial femoral head replacement in the Department of Orthopaedics,this hospital from December 2017 to December 2020 were retrospectively analyzed.They were divided into observation group and control group according to the use of ordinary steel wire or greater trochanter plate internal fixation.78 patients in the observation group were fixed with ordinary steel wire,while 22 patients in the control group were fixed with greater trochanter plate.The operation time,intraoperative blood loss,hospitalization expenses,hospitalization time,postoperative complications,hip joint visual analogue scale(VAS)score and Harris score were used to evaluate the clinical efficacy of the two groups.Results The patients were followed up for 6-18 months,with an average of(10.89±4.29)months.By the last follow-up,13 patients had died,including four in the control group and nine in the observation group.All patients successfully completed the operation,and the difference of Tronzo-Evans classification be-tween the two groups was statistically significant(P<0.05).There was no significant difference in other gen-eral data(P>0.05).There were no significant differences in hospitalization time,intraoperative blood loss,hip VAS score and Harris score at the last follow-up between the two groups(P>0.05).The operation time of the observation group was shorter than that of the control group,and the hospitalization cost was lower than that of the control group,the differences were statistically significant(P<0.05).The incidence of postopera-tive complications in the observation group was lower than that in the control group,the difference was statis-tically significant(P<0.05).Conclusion Although the ordinary steel wire binding fixation has more advanta-ges than the trochanter plate fixation in terms of operation time,hospitalization expenses and postoperative complications,the application of the trochanter plate can simplify the operation and make the fixation more re-liable during the operation,which is especially suitable for patients with complex intertrochanteric fractures.The choice of the two methods depends on the degree of fracture and the actual situation of the patient,and there is no uniform standard at present.
The elderlyIntertrochanteric fracturesArtificial femoral head replacementSteel wireLarge trochanter steel plate
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