Reconstruction Scheme of Cancellous Bone Screw Post Combined With Large- and Small-Thick Steel Wire Mesh in Hemihip Replacement Surgery for Unstable Intertrochanteric Fractures in the Elderly.

Abstract

<h4>Aim</h4>Evaluation of the clinical efficacy of pedicle screw fixation combined with hemiarthroplasty versus simple hemiarthroplasty in elderly patients with unstable intertrochanteric fractures of the femur.<h4>Methods</h4>This retrospective analysis included 81 elderly patients with unstable intertrochanteric femoral fractures who underwent hemihip replacement surgery at the Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, between May 2018 and May 2023. The patients' clinical data were collected and statistically analyzed. Study participants were divided into two groups: the experimental group (n = 40; those treated with the pile-building net fixation method combined with hemiarthroplasty) and the control group (n = 41; patients who received only hemiarthroplasty). The perioperative indicators, postoperative joint function scores, activities of daily living scores, and basic conditions of complications associated with surgical intervention were compared between the two groups.<h4>Results</h4>Comparison of perioperative indicators between the experimental and control groups revealed that the experimental group experienced significantly longer operation time and greater intraoperative blood loss than the control group (p < 0.05). Similarly, the average fracture healing time was significantly shorter in the experimental group than in the control group (p < 0.05). Six months postoperatively, the degree of hip joint pain, limping, walking distance, total Harris hip score, and Barthel index score were all found to be significantly higher in the experimental group compared to the control group (p < 0.05). In the experimental group, one case developed a urinary tract infection and two cases had a pulmonary infection after the operation. In the control group, one case showed deep vein thrombosis, two patients had delayed fracture healing, three patients had pulmonary infection, and one case had prosthesis loosening. Moreover, there was no statistically significant difference in the complication rate between the two groups (p > 0.05).<h4>Conclusions</h4>Although the pile-building net fixation method in hemiarthroplasty for unstable intertrochanteric fractures in elderly patients can prolong the operation time and increase blood loss, it facilitates fracture healing and improves postoperative joint function recovery, indicating potential clinical benefit.