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BACKGROUND: Digital three-dimensional reconstruction technology is gradually applied to orthopedic diseases with the advantages of visualization, accuracy and non-invasiveness, but there is less evidence-based support for its use in artificial hip hemiarthroplasty for intertrochanteric fractures of the femur in the elderly. OBJECTIVE: To investigate the application value and economic effects of digital three-dimensional reconstruction techniques in artificial hip hemiarthroplasty of intertrochanteric fractures of the femur in the elderly. METHODS: One hundred and thirty elderly patients with intertrochanteric femur fractures admitted to Zunyi First People’s Hospital from January 2019 to December 2022 were selected and randomly divided into a control group (n=65) and an observation group (n=65). Artificial hip hemiarthroplasty was performed in both groups. The control group adopted the film template measurement method for manual preoperative planning while the observation group adopted a digital three-dimensional reconstruction technique. Preoperative planning and intraoperative actual application of prosthesis compliance rate, fibrinogen, D-dimer, bilateral femoral eccentric distance difference, bilateral lower limb length difference, Harris hip function score, visual analog scale score, excellent and good rate of hip function, complications, and hospitalization cost were observed in both groups. RESULTS AND CONCLUSION: (1) The proportion of acetabular side and femoral side prosthesis in grade 0 (fully compliant) was higher in the observation group than that in the control group (P < 0.05). (2) Fibrinogen and D-dimer levels in the observation group were lower than those in the control group 3 days after surgery (P < 0.05). (3) The difference in bilateral femoral eccentric distance and the difference in bilateral lower limb length in the observation group were smaller than those in the control group immediately after surgery (P<0.05). The differences in Harris and visual analog scale scores were not significantly different between the two groups preoperatively, 6 and 12 months postoperatively (P > 0.05). There was no significant difference in excellent and good rate of hip function between the two groups 12 months postoperatively (P>0.05). (4) There was no significant difference in the complication rate between the two groups (P > 0.05). The hospitalization cost of the observation group was higher than that of the control group (P<0.05). (5) It is indicated that digital threedimensional reconstruction technology applied in artificial hip hemiarthroplasty of intertrochanteric femoral fracture in the elderly can not only accurately determine the prosthesis type before surgery, but also accurately reconstruct the bilateral lower limbs offline, but its hospitalization cost is high. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early surgical treatments, mainly including internal fixation and joint replacement, are favored for unstable or significantly displaced proximal humeral fractures in clinical practice. However, there is still a controversy on the specific regimen for elderly osteoporotic patients. OBJECTIVE: To compare the clinical outcomes of Trigen intramedullary nailing versus shoulder hemiarthroplasty for varus proximal humeral fractures. METHODS: A retrospective study was performed on 54 patients with varus proximal humerus fractures treated with intramedullary nailing or shoulder hemiarthroplasty in the General Hospital of Central Theater Command from January 2016 to January 2019. There were 22 males and 32 females. According to the different treatment methods, all the patients were divided into two groups: 35 patients in the intramedullary nail group and 19 patients in the shoulder hemiarthroplasty. Operation time, intraoperative blood loss, length of hospital stay and shoulder joint mobility, Visual Analogue Scale score, Constant-Murley shoulder joint score, and complications at the last follow-up were recorded and compared between two groups. RESULTS AND CONCLUSION: There was no significant difference in the preoperative data between the intramedullary nail group and the shoulder hemiarthroplasty group (P > 0.05), and they were comparable. The operation time of the intramedullary nail group [(59.6±14.3) minutes] was significantly shorter than that in the shoulder hemiarthroplasty group [(95.7±17.2) minutes] (P < 0.05). The intraoperative blood loss in the intramedullary nail group [(78.5±18.9) mL] was significantly lower than that in the shoulder hemiarthroplasty group [(203.7±23.1) mL] (P < 0.05). There were no significant differences in hospitalization time and follow-up time between the two groups (P > 0.05). The intramedullary nail group was superior to the shoulder hemiarthroplasty group in shoulder mobility and Constant-Murley shoulder joint score at the last follow-up, and the differences were statistically significant (P < 0.05). There were no significant differences in Visual Analogue Scale score and complications at the last follow-up between the two groups (P > 0.05). To conclude, both intramedullary nail and shoulder hemiarthroplasty are effective surgical procedures for proximal humeral fracture with varus deformity. Intramedullary nailing is more invasive, with better recovery of shoulder function. [ABSTRACT FROM AUTHOR]