Clinical Effects of Different Surgical Procedures for Hip Replacement in the Treatment of Elderly Patients with Failed Internal Fixation of Hip Fracture and Their Impact on Hip Joint Function

PAN Heng; SONG Xiongying; LI Gong

doi:10.3969/j.issn.1002-3429.2025.03.012

Abstract：Objective To compare the clinical effect of different surgical procedures for hip replacement in the treat-ment of elderly patients with failed internal fixation of hip fracture.Methods Clinical data of 80 elderly patients with failed internal fixation of hip fracture admitted to Department of Surgery of our hospital from January 2012 to January 2022 were retro-spectively analyzed.They were divided into the control group(undergoing half hip replacement,n=39)and the observation group(undergoing total hip replacement,n=41)according to different surgical plans.The clinical indexes,Harris hip score,clinical efficacy,and biochemical indexes of bone metabolism[bone alkaline phosphatase(BALP),bone glaprotein(BGP),procollagen ⅠN-terminal propeptide(PⅠNP)and tartrate-resistant acid phosphatase 5b(TRACP-5b)]were com-pared between the two groups,and the incidence of postoperative complications was calculated between the two groups.Results All the 80 patients were successfully operated and followed up for a mean of(6.16±0.38)months.The duration of operation and the time to off-bed activity of observation group were longer than those of control group,and the intraoperative blood loss was greater than that of control group(P＜0.05).With the extension of postoperative time,the Harris hip score of the two groups showed an increasing trend,which was higher in the observation group than in the control group at 1,3 and 6 months after operation(P＜0.05).At 6 months after operation,the overall excellent and good rate of the observation group[95.12%(39/41)]was higher than that of the control group[79.49%(31/39)],suggesting significant differences(P＜0.05).At 6 months after operation,the levels of BALP,BGP and PⅠNP in the two groups increased,and the levels of TRACP-5b decreased;the levels of BALP,BGP and PⅠNP in observation group were higher than those in control group,while the levels of TRACP-5b were lower than those in control group(P＜0.05,P＜0.01).There was no significant differ-ence in the incidence of complications between the two groups(P＞0.05).Conclusion Compared with half hip replace-ment,total hip replacement has better clinical efficacy and better bone metabolic capacity,and does not increase the risk of complications in elderly patients with failed internal fixation of hip fracture.