Comparison of three surgical strategies for unstable intertrochanteric femoral fractures in the elderly
Objective To compare the safety and effectiveness of three surgical strategies for unstable intertrochanteric femoral fractures in the elderly.Methods A total of 81 elderly patients with unstable intertrochanteric femoral fracture admitted to the First People's Hospital of Qujing City from August 2020 to May 2023(32 males and 49 females,with the minimun age of 66 years and the maximum age of 103 years,with an average age of 79±11.6 years)were continuously selected and divided into artificial femoral head replacement group(AFHR),proximal femoral anti-rotation intramedullary nail fixation group(PFNA)and proximal femoral locking plate fixation group(PFLP).Intraoperative blood loss,postoperative weight-bearing time,operative time and complications were observed.The good rate of Harris hip function score was evaluated 12 months after surgery.Results The intraoperative bleeding in PFNA group was less than that in PFLP group and AFHR group(120.39±49.76mL VS 243.53±102.22mL VS 194.62±65.62mL,P＜0.01).There was no difference in operation time among the three groups(78.07±7.26min VS 86.59±9.55min VS 82.66±13.38min,all P＞0.05).The time to get out of bed in AFHR group was significantly shorter than that in PFNA group and PFLP group(1.88±0.65d VS 4.03±0.78d VS 6.00± 1.00d,P＜0.01).The weight bearing time of AFHR group was significantly shorter than that in PFNA group and PFLP group(0.40± 0.13W VS 7.26±2.15W VS 10.24±1.72W,P＜0.01).At 12 months follow-up,the good rate of hip function of AFHR and PFNA groups was better than that of PFLP group(84.6％VS 84.2％VS 76.5％,P＜0.05),there was no difference between AFHR and PFNA groups(84.6％VS 84.2％,P＞0.05).Conclusions AFHR,PFNA and PFLP are effective strategies for the treatment of unstable intertrochanteric fractures in the elderly.AFHR strategy has the advantages of short operation time,early getting out of bed and satisfactory functional recovery,which significantly improves patients'quality of life.
万方数据
维普
