Curative effect comparison of total hip replacement and internal fixation in the treatment of fresh displaced femoral neck fracture in the elderly

HUANG Shen

doi:10.3969/j.issn.1009-4237.2016.04.009

Abstract：Objective To compare the clinical effect of hip joint replacement and percutaneous hollow screw internal fixation .Methods Clinical data of 77 elderly patients with fresh displaced femoral neck fracture were analyzed retrospectively.All cases were divided into the hip replacement group (n=40) and the internal fixa-tion group ( n=37) according to the operation method .Differences in the recovery of hip function and other indexes were compared between the two groups .Results The operation time [(98.6 ±7.3)min],blood loss [(483.6 ± 57.2)mL],hospitalization time [(19.6 ±3.4)d],hospital costs [(35089 ±5632)yuan] in the hip replacement group were significantly more than those in the internal fixation group and the differences were statistically significant ( P<0.05) .Harris scores in the first three months ,six months and the last follow-up in the hip replacement group were higher than those in the same period in the replacement group with statistically significant differences ( P<0.05).The ambulation time was (12.8 ±2.5) days in the replacement group , shorter than that in the internal fix-ation group with statistical significance (P<0.05).The excellent and good rate was 92.50% in the hip replace-ment group at the last follow-up,which was significantly higher than that of the internal fixation group (72.97%) and the difference was statistically significant ( P <0.05 ) . The complication rate in the hip replacement group (7.50%) was significantly lower than that of the internal fixation group (24.32%) and the difference was statistically significant(P<0.05).Conclusion Hip replacement for fresh displaced femoral neck fracture has better results than percutaneous cannulated screw fixation .While the operative time ,blood loss and hospital costs are higher .