Analysis of the clinical effect of total hip arthroplasty in the treatment of femoral neck fracture in the elderly
Objective To study the clinical effect of total hip arthroplasty in the treatment of femoral neck fracture in the elderly.Methods A total of 86 elderly patients with femoral neck fracture were divided into the control group and the observation group according to random numerical table,with 43 cases in each group.The control group received artificial femoral head replacement,and the observation group received artificial total arthroplasty.Both groups were compared in terms of inflammatory factors[interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),5-hydroxyserotonin(5-HT)],perioperative relevant indicators(amount of intraoperative bleeding,amount of postoperative drainage,operation time,length of hospital stay),numerical rating scale(NRS)score,Harris hip score(HHS),hip function recovery,occurrence of complications,and hip range of motion.Results At 6 months after surgery,the levels of IL-1,TNF-α and 5-HT in both groups were lower than those before surgery;the observation group had IL-1 of(2.20±0.24)pg/ml,TNF-α of(9.75±1.50)pg/ml and 5-HT of(97.66±8.23)ng/ml,which were lower than(4.20±0.38)pg/ml,(14.52±2.16)pg/ml and(158.37±10.91)ng/ml in the control group(P<0.05).The observation group had amount of intraoperative bleeding of(372.84±26.79)ml and amount of postoperative drainage of(301.58±25.34)ml,which were higher than(348.69±24.36)and(154.27±13.62)ml in the control group;the observation group had operation time of(91.44±9.45)min and length of hospital stay of(24.20±1.96)d,which were longer than(80.56±8.73)min and(20.04±1.77)d in the control group(P<0.05).NRS scores at 6,12 and 24 h after surgery were(3.41±0.50),(2.10±0.27)and(1.10±0.12)points in the observation group,which were lower than(4.57±0.69),(3.24±0.33)and(1.86±0.25)points in the control group(P<0.05).The complication rate of the observation group(2.33%)was lower than that of the control group(16.28%)(P<0.05).HHS scores at 1,3 and 6 months after surgery were(76.63±5.60),(80.25±5.84)and(84.71±6.20)points,which were higher than(70.59±4.50),(75.66±5.14)and(78.34±5.42)points in the control group(P<0.05).The excellent rate of hip function recovery in the observation group(95.35%)was higher than that in the control group(79.07%)(P<0.05).The degrees of hip flexion,dorsiflexion,adduction and abduction in the observation group were(106.25±9.58),(8.74±1.30),(24.45±3.17)and(37.25±4.40)°,which were greater than(91.05±7.33),(8.16±1.05),(19.35±2.87)and(31.68±3.46)°in the control group(P<0.05).Conclusion Total hip arthroplasty is safe and effective for elderly patients with femoral neck fracture.
Old ageFemoral neck fractureTotal hip arthroplasty
NETL
NSTL
万方数据
维普
