Analysis of clinical efficacy and prognostic factors in the treatment ofintertrochanteric fractures with hip arthroplasty
Objective To analyze the clinical efficacy of hip arthroplasty for the intertrochanteric fracture,and to explore factors that may af-fect the postoperative clinical efficacy.Methods A retrospective analysis was conducted on 96 elderly patients with femoral intertrochanteric frac-tures admitted to our department from November 2012 to August 2022 to evaluate their postoperative efficacy.There were 28 males and 68 females,with an average age of 81.78 years,ranging from 61 to 94 years old.All enrolled patients were treated with hip replacement surgery,with complete follow-up data.They were divided into two groups:Fresh intertrochanteric fracture surgery group(F-IF group,82)and Old intertrochanteric fracture surgery group(O-IF group,14).The clinical efficacy was evaluated in terms of mortality at the last follow-up after surgery and Harris score of hip joint function at least half a year after surgery.Factors that may be related to prognosis(Gender,age,preoperative course of disease,fracture classification,whether old fractures are associated,total or half hip replacement surgery,whether blood transfusion performed after surgery,the number of preopera-tive underlying diseases,whether complications,the number of complications,and whether large and small tuberosities bound with steel wire in imag-ing)were included in a univariate study.Then,whether it is an old intertrochanteric fracture of the femur wa assigned as a dependent variable for grouping(whether it is represented by"1"or not is represented by"0"),and the above included factors were used as covariates.Then,the statistically significant risk factors in univariate analysis were analyzed using binary logistic regression analysis to further analyze the risk factors that affect the prognosis of the patient.Results All 96 patients were followed up for 6 months to 10 years.The mortality rate within half one year of follow-up was 10.4%(10/96).The postoperative blood transfusion rate was 75%,and the overall incidence of complications was 65.6%.The function of the hip joint after surgery was compared with that before surgery using an independent sample T-test,with a P value of 0.00,which was statistically signifi-cant.By grouping and comparing F-IF and O-IF,and conducting ANOVA univariate test,it was concluded that preoperative course length(P=0.00),intraoperative fixation of large and small tuberosities(P=0.038),and total hip replacement surgery(P=0.002)were prognostic factors.Further Binary Logistic Regression Analysis showed that total hip arthroplasty(P=0.010)for patients with femoral intertrochanteric fractures was an independent risk factor affecting postoperative outcomes.Conclusion The treatment of femoral intertrochanteric fractures with hip replacement has achieved satisfac-tory results,but the overall postoperative blood transfusion rate is high and the overall complication rate is high.Total hip arthroplasty for patients with intertrochanteric fractures is an important prognostic factor.
Intertrochanteric fracture of femurHip replacementPrognostic factorsClinical efficacy
NETL
NSTL
万方数据
维普
