Investigation on wire binding methods for hemihip replacement of intertrochanteric fracture in elderly patients

Objective To explore the effect of artificial hemiarthroplasty combined with cross double ring wire binding and common ring wire binding in the treatment of elderly intertrochanteric fracture. Methods A total of 114 elderly patients with intertrochanteric fracture were selected in Xintang hospital of Zengcheng District from January 2013 to March 2017. The patients of age≥75 years old, Evans type Ⅲ or Ⅳ non pathological fractures were included, while the patients of pathologic fractures, severe organ dysfuctions, severe osteoarthritis and neurodegenerative diseases were excluded. The patients were randomly divided into group A and group B with 57 patients in each group. The patients were all treated by artificial hemiarthroplasty. The greater trochanter was reconstructed by conventional wire binding in group A, while it was reconstructed by cross double ring wire binding in group B. The operation time, the amount of bleeding in the operation, the time of first step out of bed, the time of postoperative hospitalization, the Harris scores at one month, three months and six months after operation and the incidence of postoperative complications were observed. The t test was used for measurement data, repeated measurement data variance were used for analysis of different time points between groups, chi-square test was used for counting data. Results There was no significant difference in operation time, the amount of blood loss during the operation and the flow rate after operation between two groups (t=-0.397, 0.943, -0.501, P>0.05). The time of walking and the time of hospitalization in group B were significantly lower than that in group A (t=2.152, 2.433, P<0.05). The Harris scores of the group B at one months, six months and 12 months were significantly higher than those of the group B(t=-2.267, -2.396 and -2.554, P<0.05). The incidence of complications in one year of group B was lower than that in group A (χ2=0.028, P <0.05). Conclusion The artificial hemiarthroplasty combined with cross double ring wire binding in the treatment of elderly intertrochanteric fracture is beneficial to the early function exercising of the patients, and can improve the function of the hip joint and reduce the postoperative complications, which is worthy of further study. Key words: Hip fractures; Hip joint; Arthroplasty; Bone wires