HEMIARTHROPLASTY COMBINED WITH GREATER TROCHANTER REATTACHMENT DEVICE FOR TREATING INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGWei ,  LILiangman , LIANGQingwei , GUShizhong , CONGLin , WUJie , ZHAOWei

Department of Orthopedics, the First Affiliated Hospital of China Medical University, Shenyang Liaoning, 110001, P. R. China;

Corresponding?author：

LILiangman, Email: liliangman@sina.com

Keywords：

Intertrochanteric fracture; Hemiarthroplasty; Greater trochanter reattachment device; Elderly patient

DOI：

10.7507/1002-1892.20140181

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effectiveness of hemiarthroplasty combined with greater trochanter reattachment device for intertrochanteric fractures in elderly patients. Methods A retrospective analysis was made on the clinical data of 34 patients (35 hips) with intertrochanteric fractures underwent hemiarthroplasty combined with greater trochanter reattachment device between February 2010 and April 2013.Of 34 patients,16 were males (16 hips) and 18 were females (19 hips),and the mean age was 85.6 years (range,77-95 years).All fractures were caused by falling.The left hip was involved in 20 cases,the right hip in 13 cases,and the bilateral hips in 1 case.There were 33 cases (34 hips) of fresh fracture,and 1 case (1 hip) of old fracture.Fractures were rated as type Ⅲ in 6 cases (6 hips),type IV in 11 cases (11 hips),and type V in 17 cases (18 hips) according to Evans-Jensen standard.All of the patients had different degree of osteoporosis and internal diseases. Results All patients underwent surgery successfully.The operation time was 70-90 minutes (mean,76.6 minutes);the intraoperative blood loss was 260-400 mL (mean,301.5 mL);the postoperative drainage was 80-530 mL (mean,290.6 mL);and the hospitalization time was 10-12 days (mean,11.7 days).Postoperative infection of incision occurred in 1 case,which was cured after dressing;primary healing of incision was obtained in the other patients.No lower extremity deep vein thrombosis or other complications was observed.Twenty-six cases (27 hips) were followed up 12-48 months (mean,21.3 months).X-ray examination showed fracture healing,and the healing time was 2.5-3.5 months (mean,2.8 months).There was no dislocation,prosthesis loosening,dislocation,loosening of titanium cable,periprosthetic osteolysis,or other complications during the follow-up period.According to Harris hip score,the results were excellent in 8 hips,good in 15 hips,fair in 4 hips,and the excellent and good rate was 85.2% at 1 year after operation. Conclusion The hemiarthroplasty combined with greater trochanter reattachment device is a feasible and effective method to treat intertrochanteric fractures in the elderly patients.It can allow early ambulation and improve quality of life,but it is necessary to strictly control the indications,and perioperative management should be paid attention.

Citation： ZHANGWei, LILiangman, LIANGQingwei, GUShizhong, CONGLin, WUJie, ZHAOWei. HEMIARTHROPLASTY COMBINED WITH GREATER TROCHANTER REATTACHMENT DEVICE FOR TREATING INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(7): 814-817. doi: 10.7507/1002-1892.20140181 Copy

1.	Heini PF,Franz T,Fankhauser C,et al.Femoroplasty-augmentation of mechanical properties in the osteoporotic proximal femur:a biomechanical investigation of PMMA reinforcement in cadaver bones.Clin Biomech (Bristol,Avon),2004,19(5):506-512.
2.	Pioli G,Barone A,Giusti A,et al.Predictors of mortality after hip fracture:results from 1-year follow-up.Aging Clin Exp Res,2006,18(5):381-387.
3.	曹磊,紀方.股骨粗隆間骨折治療方法進展.中國矯形外科雜志,2008,16(4):276-278.
4.	Bridle SH,Patel AD,Bircher M,et al.Fixation of intertrochanteric fractures of the femur.A randomised prospective comparison of the gamma nail and the dynamic hip screw.J Bone Joint Surg (Br),1991,73(2):330-334.
5.	楊艷玲,王軍霞,馬方.高齡轉子間骨折人工股骨頭置換患者術后生活質量評價.河南外科學雜志,2007,13(3):32-33.
6.	肖永志,杭志剛,劉艷華.粗隆間骨折的后內側骨皮質連續性重建方法及意義.中國矯形外科雜志,2006,14(20):1589-1591.
7.	Lee YK,Ha YC,Chang BK,et al.Cementless bipolar hemiarthroplasty using a hydroxyapatite-coated long stem for osteoporotic unstable intertrochanteric fractures.J Arthroplasty,2011,26(4):626-632.
8.	雷金來,秦四清,裴琦,等.帶大粗隆人工關節置換治療高齡不穩定股骨粗隆間骨折132例.中國骨與關節損傷雜志,2011,26(8):717-718.
9.	Yang E.New concepts in pertrochanteric hip fracture treatment.Orthopedics,2006,29(11):981-983.
10.	Clarke RP Jr,Shea WD,Bierbaum BE.Trochanteric osteotomy:analysis of pattern of wire fixation failure and complications.Clin Orthop Relat Res,1979,(141):102-110.
11.	Baril Y,Bourgeois Y,Brailovski V,et al.Improving greater trochanteric reattachment with a novel cable plate system.Med Eng Phys,2013,35(3):383-391.
12.	Hamadouche M,Zniber B,Dumaine V,et al.Reattachment of the ununited greater trochanter following total hip arthroplasty.The use of a trochanteric claw plate.J Bone Joint Surg (Am),2003,85-A(7):1330-1337.
13.	Hersh CK,Williams RP,Trick LW,et al.Comparison of the mechanical performance of trochanteric fixation devices.Clin Orthop Relat Res,1996,(329):317-325.
14.	夏春波,秦小云,沈洪濤,等.股骨距的解剖與生物力學研究.中國運動醫學雜志,2010,29(4):448-450.
15.	劉明軒,曹成福,張啟寬,等.長柄人工髖關節置換治療高齡股骨轉子間骨折的實驗及臨床研究.骨與關節損傷雜志,2003,18(7):444-446.
16.	Canet F,Duke K,Bourgeois Y,et al.Effect of force tightening on cable tension and displacement in greater trochanter reattachment.Conf Proc IEEE Eng Med Biol Soc,2011,2011:5749-5752.

1. Heini PF,Franz T,Fankhauser C,et al.Femoroplasty-augmentation of mechanical properties in the osteoporotic proximal femur:a biomechanical investigation of PMMA reinforcement in cadaver bones.Clin Biomech (Bristol,Avon),2004,19(5):506-512.
2. Pioli G,Barone A,Giusti A,et al.Predictors of mortality after hip fracture:results from 1-year follow-up.Aging Clin Exp Res,2006,18(5):381-387.
3. 曹磊,紀方.股骨粗隆間骨折治療方法進展.中國矯形外科雜志,2008,16(4):276-278.
4. Bridle SH,Patel AD,Bircher M,et al.Fixation of intertrochanteric fractures of the femur.A randomised prospective comparison of the gamma nail and the dynamic hip screw.J Bone Joint Surg (Br),1991,73(2):330-334.
5. 楊艷玲,王軍霞,馬方.高齡轉子間骨折人工股骨頭置換患者術后生活質量評價.河南外科學雜志,2007,13(3):32-33.
6. 肖永志,杭志剛,劉艷華.粗隆間骨折的后內側骨皮質連續性重建方法及意義.中國矯形外科雜志,2006,14(20):1589-1591.
7. Lee YK,Ha YC,Chang BK,et al.Cementless bipolar hemiarthroplasty using a hydroxyapatite-coated long stem for osteoporotic unstable intertrochanteric fractures.J Arthroplasty,2011,26(4):626-632.
8. 雷金來,秦四清,裴琦,等.帶大粗隆人工關節置換治療高齡不穩定股骨粗隆間骨折132例.中國骨與關節損傷雜志,2011,26(8):717-718.
9. Yang E.New concepts in pertrochanteric hip fracture treatment.Orthopedics,2006,29(11):981-983.
10. Clarke RP Jr,Shea WD,Bierbaum BE.Trochanteric osteotomy:analysis of pattern of wire fixation failure and complications.Clin Orthop Relat Res,1979,(141):102-110.
11. Baril Y,Bourgeois Y,Brailovski V,et al.Improving greater trochanteric reattachment with a novel cable plate system.Med Eng Phys,2013,35(3):383-391.
12. Hamadouche M,Zniber B,Dumaine V,et al.Reattachment of the ununited greater trochanter following total hip arthroplasty.The use of a trochanteric claw plate.J Bone Joint Surg (Am),2003,85-A(7):1330-1337.
13. Hersh CK,Williams RP,Trick LW,et al.Comparison of the mechanical performance of trochanteric fixation devices.Clin Orthop Relat Res,1996,(329):317-325.
14. 夏春波,秦小云,沈洪濤,等.股骨距的解剖與生物力學研究.中國運動醫學雜志,2010,29(4):448-450.
15. 劉明軒,曹成福,張啟寬,等.長柄人工髖關節置換治療高齡股骨轉子間骨折的實驗及臨床研究.骨與關節損傷雜志,2003,18(7):444-446.
16. Canet F,Duke K,Bourgeois Y,et al.Effect of force tightening on cable tension and displacement in greater trochanter reattachment.Conf Proc IEEE Eng Med Biol Soc,2011,2011:5749-5752.

Chinese Journal of Reparative and Reconstructive Surgery

HEMIARTHROPLASTY COMBINED WITH GREATER TROCHANTER REATTACHMENT DEVICE FOR TREATING INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content