| Objective:To investigate the best operation method for the femoral neck fracture in the elderly,This study was designed to explore functional recovery of joints in patients over 60 years with femoral neck fracture by total hip arthroplasty and hemiarthroplasty.Methods:According to inclusion criteria,We selected 75 patients of femoral neck fractures, age over 60, from affiliated hospital of traditional Chinese medicine of Hubei University from October 2008 to March 2009. Followed up for 62 cases,13 cases lost. Of them there were 25 males and 37 females with an average of 76 years old (62 to 83). The fractures were on the left side in 16 Patients and on the right side in 46 Patients. Fractures according to Garden classification:Ⅲtype 26 cases, IV type of 36 cases. Divided into two group by surgical:hip replacement group (control group) and total hip replacement group (observation group). There were 32 patients in Control group,13 males and 19 females with an average of 78.5 years old , and Garden III type in 12 cases, IV type in 20 cases. There were 30 patients in Observation group,12 males and 18 females with an average of 73.5 years old and GardenⅢin 14 cases, IV type in 16 cases. The two groups in the artificial joint operation were operated by the professional worker undergraduate above 10 years of experienced radiologists, achieved the technical standards of orthopedic surgeon specialized job qualifications. The difference was compared in time of operation, bleeding quantity,time of hospitalization, cost of hospitalization, subentry percentage hip scoring and complications incidence.Results:All patients were followed up 24 to 27 months (25 months on average). The operation time was (61.88±7.04)min (control group) and (64.13±4.70)min (observation group), the bleeding quantity was (301.25±29.15)ml (control group) and (311.50±21.93)ml (observation group) and the time of hospitalization was (17.38±1.69) days in the control group and (16.50±2.14) days in the observation group,all showing no significant difference. Operation cost was (1.98±0.17) million in the control group and (2.95±0.15)million in the observation group, showing significant difference. After 1 year, clinical efficacy and complications showing no significant difference. Clinical evaluation after 2 years of the two groups showing significant difference. and complication showing no significant difference.Conelusion:Total hip arthroplasty for femoral neck fracture in elderly patients get better treatment than the effect of hemiarthroplasty.but the operating cost of hemiarthroplasty is superior to total hip arthroplasty. Two treatment methods in operation time,bleeding quantity, time of hospitalization and complications indicators observed no significant difference. The aim of treating Femoral neck fracture should be on how to get out of bed as soon as possible,and to reduce complications and lower mortality and morbidity,improve and enhance the quality of life. Total hip arthroplasty can be used as the preferred treatment method for femoral neck fracture, and for poor physical condition, exercise less,elderly patients with poor economic conditions, hemiarthroplasty can be consider to selected to reconstruct the hip joint function. |
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