Comparison of the Efficacy and Safety of Three Surgical Methods for Treating Senile Osteoporotic Hip Fractures
WANG Yin
LI Yinpeng
HAO Ming
LI Ximing
CAO Bin
Abstract：Objective To analyze the efficacy and safety of three surgical methods for treating senile osteoporotic hip fractures:Proximal femoral nail antirotation(PFNA)internal fixation,artificial joint replacement,and a novel combined mini-mally invasive hemiarthroplasty.Methods Clinical data of 174 elderly patients with osteoporotic hip fractures in Shijiazhuang People's Hospital(2020.01-2023.01)were used as the research subjects.Patients were divided into the minimally invasive group(n=58,novel combined minimally invasive hemiarthroplasty),joint replacement group(n=58,artificial joint replacement),and internal fixation group(n=58,PFNA internal fixation)according to different surgical methods.The perioperative indicators,excellent and good rate of hip joint function,fracture recovery status,Harris score,Berg Balance Scale(BBS)score,and postop-erative complications were compared among the three groups.Results The operation time,total incision length,intraoperative blood loss,and postoperative drainage volume in the minimally invasive group and internal fixation group were shorter or less than those in the joint replacement group(P<0.05),but there was no significant difference between the minimally invasive group and the internal fixation group(P>0.05).The hospitalization time,fracture healing time,and postoperative ambulation time in the minimally invasive group and internal fixation group were shorter than those in the joint replacement group(P<0.05),but there was no significant difference between the minimally invasive group and the internal fixation group(P>0.05).At 6 and 12 months post-surgery,the Harris score and BBS score in the minimally invasive group were higher than those in the internal fixation group and the joint replacement group(P<0.05).Six months post-surgery,the rate of excellent and good hip function in the minimally invasive group(72.41%)was higher than that in the joint replacement group(51.72%)and the internal fixation group(60.34%)(P<0.05).However,there was no significant difference between the joint replacement group and the internal fixation group(P>0.05).At 12 months after surgery,there was no significant difference in the excellent and good rate of hip joint function among the three groups(P>0.05).The incidence of postoperative complications in the minimally invasive group and the internal fixation group(5.17%and 10.34%,respectively)was lower than that in the joint replacement group(24.14%)(P<0.05).Conclusion PFNA internal fixation,artificial joint replacement,and the novel combined minimally invasive hemiarthroplasty can all effectively improve the hip joint function and balance ability of elderly patients with osteoporotic hip fractures.Among them,the new combined minimally invasive hemiarthroplasty and PFNA internal fixation have better effects.
Keywords：Artificial joint replacementProximal femoral nail antirotationMinimally invasive hemiarthroplastyHip fractureHip joint functionBalance ability
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 96-102 )