Comparative analysis of hip replacement and femoral head replacement for treatment of femoral neck fractures in elderly patients

LUO Lei-feng; YUAN Wen-qi; LIU Zhao-shu

doi:10.3969/j.issn.1009-4237.2018.06.019

Abstract：Objective To explore the efficacy of total hip arthroplasty and femoral head replacement in the treatment of senile femoral neck fracture ,and to provide a basis for clinical application.Methods A retrospective analysis of 85 elderly patients with femoral neck fracture in Henan Zhoukou City Centre Hospital (hereinafter referred to as "our hospital") during Jan.and Apr.2014 was carried out.Fifty cases were treated with total hip replace-ment (hip group),and 35 patients with artificial femoral head replacement surgery (femoral head group).The peri-operative condition,preoperative and postoperative life quality and postoperative complications were compared be -tween the two groups.After 1 year,the clinical efficacy was compared.Results Surgery time in the hip group [(123.58 ±21.34)min]was significantly longer than in the femoral head group [(76.86 ±13.26)min],intraoper-ative blood loss [(428.12 ±65.60) mL] and postoperative drainage [(164.94 ±25.63) mL] were significantly more than those of the femoral head group of (229.45 ±35.86)mL,(97.56 ±19.43)mL.The postoperative posi-tive rate of the hip joint group was 78.00%,which was significantly higher than that of the femoral head group (54.28%,P＜0.05).After one year,quality of life in two groups of patients were significantly improved than be-fore surgery(P＜0.05).The hip group vigor,body pain,physical function,social function,physical function,emo-tional function,overall health outcomes were significantly better than the femoral head group (P＜0.05).There was no significant difference in the total incidence of postoperative complications (P＜0.05).Conclusion In elderly patients with femoral neck fracture ,the long-term effect of total hip arthroplasty is more significant ,and the operation of artificial femoral head replacement is simple and less traumatic.Clinically,the best surgical option can be chosen according to the specific condition of femoral neck fracture and the patient's own physical condition.