Comparison of calcar replacement arthroplasty and Intertan nail in treatment of intertrochanteric fracture in the aged

Objective To compare the clinical efficacy between calcar replacement arthroplasty and InterTan nail in treatment of intertrochanteric fractures in the aged. Methods From January 2008 to July 2013, a total of 58 elderly patients with intertrochanterie fracture , had been treated in Department of Orthopaedics, Tianjin Occupational Diseases Control and Treatment Hospital, were retrospectively compared.Half of them were treated with calcar replacement arthroplasty and half with InterTan nails.In the calcar replacement arthroplasty group, there were 8 men and 21 women, with an average age of (85.3±4.9) years, there were 8 A1, 16 A2 and 5 A3 fractures according to the AO classification.In the InterTan nail group, there were 10 men and 19 women, with an average age of (86.1±5.6) years, there were 11 A1, 15 A2 and 3 A3 fractures according to the AO classification.The 2 groups were compared in terms of the duration of the operation, intraoperative blood loss, hospitalization time, time of off-bed activity, complications, mortality rate, Harris hip score, short form 36 questionnaire score and ADL score. Results Twenty-seven patients in the calcar replacement arthroplasty group and twenty-six patients in the patients in each group were followed up InterTan nail group were follow-up for a period of 24 months.There were no significant differences between the 2 groups regarding hospitalization time, complications, mortality rate, Harris hip score, short form 36 questionnaire score and ADL score(P>0.05). However, the operative time, intraoperative blood loss, and the time of off-bed activity for the calcar replacement arthroplasty and InterTan nail groups was respectively (78±29) minutes vs (59±32) minutes, (316±185) ml vs (108±97) ml, and (15±5.8) days vs (32±12.7) days, all of them with a significant difierence(P<0.05). Conclusion The patients in the calcar replacement arthroplasty group suffered longer operative time and more blood loss, but they can obtain early off-bed activity.The hospitalization time, complications, mortality rate, hip function and quality of Life between the two were the same. Key words: Fracture fixation, intramedullary; Arthroplasty, replacement, hip; Hip fractures; Aged