COMPARING GAIT AND HIP SCORES IN FEMORAL NECK AND INTERTROCHANTERIC FRACTURES

ABSTRACT Objective Treatment modality is controversial in the unstable IT fractures. Ideal hemiarthroplasty treatment for unstable IT fractures should be comparable to that for FN fractures. Therefore, the aim of this study was to compare patients who underwent cementless hemiarthroplasty for a diagnosis of FN and unstable IT in terms of clinical outcomes, functional scores, and smartphone-based gait analysis data. Methods Case matching was applied to 50 patients with FN fracture and 133 patients with IT fracture who underwent hemiarthroplasty treatment, they were compared in terms of, preoperative and postoperative walking status, and Harris hip scores. Smartphone-based gait analysis was applied to 12 patients in the IT group and 14 patients in the FN group who could walk without support. Results There was no significant difference between patients with IT and FN fractures regarding Harris hip scores, preoperative, and postoperative walking status. In the gait analysis, gait velocity, cadence, step time, step length, and step time symmetry values were observed to be significantly better in patients in the FN group. Conclusion Cementless hemiarthroplasty operations for unstable IT fractures have similar hip scores to FN fractures. However, the walking speed and walking symmetry data were seen to be worse. This result should be considered in the selection of appropriate treatment. Level of evidence III; Retrospective study.

摘要
目的 不稳定转子间骨折（intertrochanteric fractures，IT）的治疗方式仍存在争议。针对不稳定IT骨折的理想半髋关节置换治疗方案，应与股骨颈骨折（femoral neck fractures，FN）的治疗效果相当。因此，本研究旨在对比接受非骨水泥型半髋关节置换术的FN骨折与不稳定IT骨折患者的临床结局、功能评分及基于智能手机的步态分析数据。

方法 本研究对50例FN骨折患者与133例IT骨折患者（均接受半髋关节置换术）进行病例匹配，随后对比两组患者的术前与术后步行状态、Harris髋关节评分。针对可无需辅助支撑步行的IT组12例患者及FN组14例患者，采用基于智能手机的步态分析进行评估。

结果 IT骨折患者与FN骨折患者在Harris髋关节评分、术前及术后步行状态方面均无显著差异。步态分析结果显示，FN组患者的步态速度、步频、步时、步长及步时对称性指标均显著更优。

结论 针对不稳定IT骨折的非骨水泥型半髋关节置换术，其髋关节评分结果与FN骨折患者相当，但步行速度与步行对称性数据相对较差。该结果在遴选适宜治疗方案时应予以考量。证据等级Ⅲ级；回顾性研究。