CAI Leyi,XIANG Guangheng,CHEN Hua, et al. Short-term clinical effect of artificial joint replacement in the treatment of the elderly after failure of femoral trochanteric internal fixation[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(3): 203-208,214.
Abstract：Objective: To investigate the short-term clinical effect of artificial joint replacement after failure of internal fixation of femoral trochanteric fracture in elderly osteoporosis patients. Methods: The patients with internal fixation failure of femoral trochanteric fracture who were treated at the Second Affiliated Hospital of Wenzhou Medical University between January 2010 and January 2020 with complete follow-up data were selected and treated with artificial joint replacement. Relevant clinical indicators and complications of patients were recorded, and Harris score and VAS score of hip joint of patients before and after operation were compared.Results: A total of 20 patients were included, including 14 males and 6 females, with an age range from 65 to 85 years (mean age, 74.7±5.8 years old). All patients successfully underwent the operation, with a mean operation time of (113.5±16.3)min, and the bleeding volume was (687.5±304.3)mL. Two patients suffered pulmonary infection and 1 patient had heart failure after surgery but improved with relevant medical treatment. One patient developed superficial infection, and the wound healed after oral antibiotics and dressing change. In the followup,there was one case of periprosthetic fracture, and the rest had no complications such as prosthesis loosening,prosthesis sinking, prosthesis instability, deep joint infection, joint dislocation, etc. Harris score of the hip joint of the patients in this group was 39.4±6.8 before operation, and 85.7±4.3 in the last follow-up. The preoperative VAS score was 7.2±1.0, and the final follow-up VAS score was 1.6±0.5. The preoperative SF-36 score was 43.6±7.9,and the final follow-up score was 84.5±4.1. All the three scores were significantly improved (P<0.05). Conclusion:Artificial joint replacement is an effective treatment for elderly patients with osteoporotic femoral intertrochanteric fracture who experience failure of internal fixation after surgery, with a significant short-term clinical effect that can effectively reduce hip joint pain and restore hip joint function.
