[Artificial femoral head replacement for the treatment of unstable intertrochanteric fractures in aged patients: a report 40 cases].

OBJECTIVE: To study the operative procedures, indicatrions and short-term effects of the artificial femoral head replacement for the treatment of unstable intertrochanteric fracture in aged patients.

METHODS: From January 2001 to October 2008, 40 patients with unstable intertrochanteric fractures were treated with artificial femoral head replacement. Among the patients, 9 patients were male and 31 patients were female, ranging in age from 75 to 95 years, averaged 81.1 years. The duration from injured to the hospitalization ranged from 3 to 48 hours, with a mean of 11.5 h. According to Evans classification, 8 patients were type II , 21 type III, and 11 type IV. The duration from hospitalization to operation ranged from 4 to 8 days, averaged 4.8 day. After the operation, the hip motion was observed and the preoperative and postoperative Harris scores were compared.

RESULTS: All the patients were operated successfully, and were kept in bed about 4 to 7 days, 5.9 days in average. Thirty-one patients were followed up for 6 months without loose or dislocation of prothesis, periprosthetic fractures. Fourteen patients resumed to normal activity of the hip joint while 17 patients showed the declination of hip movement. Their hip movements recovered to (66.67+/-26.35)% at 4 months after operations and (76.08+/-25.62)% at 6 months. Among 10 patients with normal ability of hip joints before their injuries were valuated with Harris system at 6 mouths after operations, the results were:5 excellent, 3 good and 2 poor.

CONCLUSION: Artificial femoral head replacement for unstable intertrochanteric fractures in aged patients is effective in the recovery of hip joint function in short time with earlier walking and decreased complications.