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

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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,纪方.股骨粗隆间骨折治疗方法进展.中国矫形外科杂志,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.	杨艳玲,王军霞,马方.高龄转子间骨折人工股骨头置换患者术后生活质量评价.河南外科学杂志,2007,13(3):32-33.
6.	肖永志,杭志刚,刘艳华.粗隆间骨折的后内侧骨皮质连续性重建方法及意义.中国矫形外科杂志,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.	雷金来,秦四清,裴琦,等.带大粗隆人工关节置换治疗高龄不稳定股骨粗隆间骨折132例.中国骨与关节损伤杂志,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,沈洪涛,等.股骨距的解剖与生物力学研究.中国运动医学杂志,2010,29(4):448-450.
15.	刘明轩,曹成福,张启宽,等.长柄人工髋关节置换治疗高龄股骨转子间骨折的实验及临床研究.骨与关节损伤杂志,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,纪方.股骨粗隆间骨折治疗方法进展.中国矫形外科杂志,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. 杨艳玲,王军霞,马方.高龄转子间骨折人工股骨头置换患者术后生活质量评价.河南外科学杂志,2007,13(3):32-33.
6. 肖永志,杭志刚,刘艳华.粗隆间骨折的后内侧骨皮质连续性重建方法及意义.中国矫形外科杂志,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. 雷金来,秦四清,裴琦,等.带大粗隆人工关节置换治疗高龄不稳定股骨粗隆间骨折132例.中国骨与关节损伤杂志,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,沈洪涛,等.股骨距的解剖与生物力学研究.中国运动医学杂志,2010,29(4):448-450.
15. 刘明轩,曹成福,张启宽,等.长柄人工髋关节置换治疗高龄股骨转子间骨折的实验及临床研究.骨与关节损伤杂志,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

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