Clinical features and surgical treatment strategies of hip arthroplasty for unhealed old femoral intertrochanteric fractures.
10.12200/j.issn.1003-0034.20230635
- Author:
Qing XIA
1
;
Chuan-Wen LIU
1
;
Yu-Cheng XIA
1
;
Hui-Yang WANG
1
;
Jin-Quan GUO
1
Author Information
1. Department of Orthopaedics, Dezhou Hospital of Shandong University Qilu Hospital, Dezhou 253032, Shandong, China.
- Publication Type:Journal Article
- Keywords:
Femoral intertrochanteric fractures;
Hip arthroplasty;
Old fractures;
Osteoporosis
- MeSH:
Humans;
Male;
Female;
Aged;
Hip Fractures/physiopathology*;
Aged, 80 and over;
Arthroplasty, Replacement, Hip/methods*
- From:
China Journal of Orthopaedics and Traumatology
2025;38(2):188-194
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the surgical method and clinical efficacy of hip arthroplasty in the treatment of old non-union femoral intertrochanteric fractures.
METHODS:Fifteen unoperated patients suffering from old non-union femoral intertrochanteric fractures from Feburary 2013 to Feburary 2023 were treated with hip arthroplasty including 9 males and 6 females, aged 71 to 82 years old. Eleven cases detected deep venous thrombosis(DVT), 9 cases received lower vena cava filter implantation. The operation time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative hemoglobin content, procedure-related complications, and the range of motion of hip flexion, abduction motion were recorded. The degree of hip pain was evaluated using a visual analogue scale(VAS). The hip Harris scores were used to evaluated the clinical efficacy.
RESULTS:All patients were followed up for 3 to 12 months. The intraoperative blood loss was 200 to 400 ml, intraoperative blood transfusion was 0 to 400 ml, and the operation time was 40 to 90 min. All 15 patients had different degrees of anemia after surgery, the 3 days postoperative hemoglobin was 72 to 97 g·L-1, and the postoperative transfusion volume was 0 to 400 ml. All patients had no periprosthetic infection, poor incision healing, lower limb deep vein thrombosis, and cerebral infarction. One case occurred in the early postoperative period, which disappeared from 4 to 5 days after operation, and there was no further revision at the last follow-up. The VAS was 6 to 7 points before operation and 2 to 4 points at latest follow-up;the hip Harris score was 2 to 13 points before operation and 73 to 84 points at latest follow-up.
CONCLUSION:The unoperated patients of old non-union femoral intertrochanteric fractures had significant clinical and imaging characteristics. Hip arthroplasty combined with or without femoral calcar reconstruction in the treatment of old non-union femoral intertrochanteric fractures had the advantages of relatively simple manipulation, rigid fixation, relatively safe operation, and relatively exact efficacy.
