Efficacy and safety of total hip arthroplasty and hemiarthroplasty in treatment of femoral neck fractures in the elderly
Objective To explore the efficacy and safety of hemi-hip and total hip joint replacement in the treatment of femoral neck fractures in the elderly.Methods A retrospective analysis was conducted on 106 elderly patients with femoral neck fractures who were admitted to our department from January 2016 to October 2019.All patients underwent hip arthroplasty following Guideline for the Diagnosis and Treatment of Adult Femoral Neck Fractures.They were divided into hemiarthroplasty group(n=53)and total hip arthro-plasty group(n=53)based on the surgical technique they received.Operational indicators,hip joint function and pain,quality of life,and safety were compared between two groups.SPSS 22.0 software was used to process the statistical analysis,and depending on data type,student's t test or Chi-square test was employed for intergroup comparison.Results There were no significant difference in the number of blood transfusion patients and length of hospital stay between two groups(P＞0.05).Compared with the hemiarthroplasty group,the total hip arthroplasty group had more intraoperative blood loss,24-h postoperative drainage and longer bed-ridden time(P＜0.05).In three months after surgery,the Harris hip score(HHS)was increased,the number of unequal length cases was decreased,and the score of Visual analogue scale(VAS)of pain was reduced in both groups when compared with the conditions before surgery.The HHS score was obviously higher and VAS score was notably lower in the hemiarthroplasty group than the total hip arthroplasty group(P＜0.05),but no significant difference was found in the number of unequal length cases between two groups in three months postoperatively(P＞0.05).The results of medical outcomes study 36-item short from health survey(SF-36)in three months after surgery showed there were no significant differences in the scores of overall health status,social function and emotional function between two groups(P＞0.05),but the total hip arthroplasty group had higher SF-36 scores of physiological function,role-physical,physical pain,vitality and mental health than the hemiarthroplasty group(P＜0.05).The complication rate was 3.77％(2/53)in the total hip arthroplasty group,which was significantly lower than that of hemiarthroplasty group[16.98％(9/53),P＜0.05].Conclusion Hemiarthroplasty and total hip arthroplasty have their own advantages in the treatment of elderly patients with femoral neck fractures.For those with poor preoperative general condition and low postoperative functional requirements,it is advisable to undergo hemiarthroplasty.While,for those with good preoperative general condition and certain requirements for postoperative functional recovery,total hip arthroplasty is recommended.
agedtotal hip arthroplastyfemoral neck fracturetherapeutic efficacycomplications
万方数据
维普
