Comparative study on the therapeutic effects of internal fixation and replacement arthroplasty on fracture of femurs haft in elderly patients

doi:10.3969/j.issn.1002-7386.2017.04.005

Abstract：Objective To investigate the therapeutic effects and safety of internal fixation and replacement arthroplasty on fracture of femurs haft in elderly patients .Methods Three hundred elderly patients with fracture of femurs haft who were treated in our hospital from January 2011 to March 2015 were divided into replacement arthroplasty group and internal fixation group , moreover , replacement arthroplasty group was redivided into total hip replacement and half hip replacement group,and internal fixation group was redivided into DHS subgroup and PFNA subgroup .The generral conditions of patients, operation time,bleeding volume during operation ,lying in bed time,postoperative full weight-bearing time, Harris hip scoring before and after operation and during follow -up,Oswestry disability index ( ODI ) and incidence rates of postoperative complications were observed and compared among groups .Results There were no significant differences in gender,age,complicatins between two groups ( P <0.05).There was no significant difference in operation time among the four subgroups ( P >0.05).However there were significant differences in bleeding volume during operation ,lying in bed time,postoperative full weight-bearing time among the four subgroups ( P <0.05).There were significant differences in ODI and Harris scores between replacement arthroplasty group and internal fixation group ( P <0.05).Moreover the incidence condition of postoperative complications in replacement arthroplasty group was superior to that in internal fixation group ( P <0.05).Conclusion the replacement arthroplasty in treatment of fracture of femurs haft in elderly patients can effectively reduce lying in bed time and postoperative full weight-bearing time, and can decrease incidence rate of complicatins , with quicker joint function recovery ,therefor,which is an effective operation mode to treat fracture of femurs haft in elderly patients , so, it is suggested to use the treatment way as much as possible in clinical practice .