To evaluate the effect of artificial femoral head replacement combined with fast tract surgery in the treatment of aged unstable femoral intertrochanteric fractures patients.

Ninety patients with femoral intertrochanteric fractures of the Department of Joint Surgery, Chifeng Municipal Hospital from April 2016 to September 2017 were divided into fast track group and control group according to the random number table method. The fast track group (n=46) was established by the evidence based medicine in the perioperative period and strictly implement the fast track rehabilitation program. In control group (n=44), conventional surgical management mode was followed. The early postoperative pain numerical rating scale (NRS) score, blood transfusion rate, nausea and vomiting incidence, thirst, hunger and abdominal distension incidence rate, hospitalization time, the satisfaction of 2 weeks after operation, 3 months′ Harris score after operation, and the incidence of postoperative complications were compared between the two groups. The data were analyzed by t test and chi-square test.

At 12, 24, and 48 h after operation, the NRS score of patients in the fast track group were (3.23±1.32), (2.42±1.51), (1.53±1.12) points, which were lower than those in the control group [(4.40±1.52), ( 3.62 ± 1.41), (2.43 ± 1.22) points], the differences were statistically significant (t= 3.9039, 3.8924, 3.6481, P=0.0002, 0.0002, 0.0004); postoperative blood transfusion rate was 15.2%(5/46) in the fast track group, it was considerably lower than the 47.7%(21/44) in control group, the difference was statistically significant (χ²=9.6251, P=0.0019). The incidence of postoperative nausea and vomiting was 10.9% (5/46) in the fast track group, which was lower than that in the control group [34.1% (15/44)], the difference was statistically significant (χ²=5.7370, P=0.0166). The rate of thirst, hunger, and bloating in the fast track group was 13.0% (6/46), which was lower than that in the control group [40.9% (18/44)], the difference was statistically significant (χ²=7.5616, P=0.0060). The hospitalization time in patients of the fast track group was (4.3±1.1) days, which was less than that of the control group [(6.8±1.7) days]. The difference was statistically significant (t=8.3191, P<0.05). The patients′ satisfaction degree at 2 weeks after operation in the fast track group was (9.6±1.2) points, which was higher than that of the control group [(8.8±1.6) points], the difference was statistically significant (t=2.6912, P=0.0085). The hip function Harris scores were (89.2±12.3) and (88.5±11.6) points in the fast track group and control group at 3 months postoperatively, there was no significant difference between the two groups (t=0.2774, P=0.7821). The incidence of complications in the fast track group was 2.2%(1/46), which was lower than that in the control group [18.2%(8/44)], the difference was statistically significant (χ²=4.7480, P=0.0293).

The use of artificial femoral head replacement combined with the concept of fast tract surgery for the treatment of femoral intertrochanteric fractures in the elderly can shorten the length of hospital stay, enable patients to quickly restore daily activities, and improve patient satisfaction. It is a safe and reliable choice.