Treatment of femoral intertrochanteric fractures in elderly patients（over 95 years） with hip arthroplasty

Objective: To investigate treatment of femoral intertrochanteric fractures in elderly patients over 95 years old with hip arthroplasty.Methods: There were 10 cases in the group,3 males and 7 females,aged 95～99 years with an average of 96.5 years.Arthroplasty was performed in 12 sides（2 cases with both sides）,of which,artificial femoral head was performed in 11 sides,and total hip joint replacement was performed in 1 side.11 sides in 9 cases were fresh comminuted femoral intertrochanteric fracture,according to the classification of Evans,there were 2 cases of type ⅢA,5 cases of type ⅢB and 4 cases type Ⅳ fractures.1 case was hip osteo-arthritis secondary to the malunion of femoral intertrochanteric fracture.All 10 patients had more than 5 kinds of concomitant diseases.They could walk with canes,and take care of themselves partly before the fracture.Of the 9 cases with fresh fractures,2 cases were operated on emergently on the day admitted to the hospital,and 9 cases were operated on within 3 days after admitted to the hospital.Careful examination,medical and aneathesiological consultations were taken to confirm the indications,and to adjust the patients′ conditions.Special attention should be paid to the preservation of large peri-trochanteric fragments during the operation and bone defects were stuffed with bone cement.Results: All operations were successful.3 cases began protected ambulation within 7 days,5 cases within 8-14 days postoperatively.Complications: psychological disorders after the operation in 5 patients,infection of the lung in 2 patients,and prolonged healing of the drainage in 2 patients.All the complications were gradually recovered after appropriate treatments.1 patient died during the period of hospitalization.8 cases were followed up for 5 to 12 months with an average of 7 months after discharged from hospital.3 patients could walk indoors with walking aid,3 patients could walk with walking aid and personal assistance.2 patient died of other diseases in 3,5 months,respectively.Conclusion: It′s an effective method to treat the intertrochanteric fracture with hip arthoplasty in elderly patients over 95 years.It can reduce the mortality,and improve the patients′ quality of life.