To investigate the clinical effect of lengthened distal stable biological femoral stem prosthesis hemiarthroplasty in the treatment of elderly patients with intertrochanteric fractures.

A total of 94 elderly patients (75~95 year old) with unstable intertrochanteric fractures in Mianyang Orthopaedic Hospital during Jan. 2009 to Dec. 2015 were divided into the cement group and the biological group by random number table, 47 cases in each group. Inclusion creteria were unstable intertrochanteric fracture after trauma, and no contraindication for surgery. The cement group was treated by hemiarthroplasty with bone cement prosthesis, and the biological group was treated with lengthened biological prosthesis. the operation time, intraoperative blood loss, total perioperative blood loss, postoperative complications, first postoperative calcification time, postoperative hospital stay, and postoperative Harris scores were compared between the two groups by t test using SPSS 23.0 software. The excellent rates were compared by chi-square test.

The operation time, intraoperative blood loss of biological group were lower than those of bone cement group (time: t =3.733, blood loss: t =2.207, both P<0.05), and there was no significant difference between the two groups in perioperative blood loss, first ambulant time and postoperative hospital stay (P>0.05). There was no significant difference between the two groups in the rate of operative site infection and periprosthetic fracture (P>0.05). The incidence of deep venous thrombosis (DVT) and cardiopulmonary events (CPE) in the biological group was significantly lower than that in the cement group (DVT: χ² =4.642, CPE: χ² =6.409, both P<0.05). There was no significant difference between the two groups in Harris scores at three months, six months and 12 months after the operation(P >0.05). There was no significant difference between the two groups in excellent rate at 12 months after the operation (P >0.05).

The long distal stable biological femoral stem prosthesis for hemiarthroplasty in treatment of the elderly patients with intertrochanteric fractures can achieve the same clinical effect as bone cement prosthesis, and can reduce trauma and the incidence of postoperative complications.