Clinical Therapeutics Comparative Efficacy Of BFHR Versus Thr In Treating Elderly Patients With Femoral Neck Fracture

Objective:To investigate the best operation method for the femoral neck fracture in the elderly by following-up the old patients with femoral neck fracture who were treated by BFHR and THR and analyzing its clinical results.Methods:Follow-up the old patients with femoral neck fracture who were operated with BFHR and THR in the First Affiliated Hospital of Soochow University from March 2004 to February 2010. We all get 74 cases, in which 42 cases operated with bipolar femoral head replacement, 32 cases operated with total hip replacement. In the BFHR group, there are 7 males and 35 females, and age from 65 to 91(average 77.3); In the THR group, there are 9 males and 23 females, age from 65 to 90(average 74.8). We compared the two groups from operative time, intra-operative blood loses, intra-operative blood transfusion,postoperative drainage, hospitalization period, cost of hospitalization, early postoperative complications, long-term postoperative complications, and postoperative recovery of hip function.Results: Two groups of patients are interviewed randomly from 1 year to 6.5 years, 3.2 years on average. There was no significant difference between BFHR group with THR group in hospitalization period, postoperative drainage, early postoperative complications and 1 year postoperative recovery of hip function(P>0.05). However, operative time, intra-operative blood loses, intra-operative blood transfusion, long-term postoperative complications, 3 years and 5 years postoperative recovery of hip function between the two groups showed significant difference (P<0.05). Conclusions: 1. Both bipolar femoral head replacement and total hip replacement are well performed in the femoral neck fracture in elderly patients when strict choosing surgical adaption in the short-time following-up, the patients' hip function can recover to the lever before injury quickly, and improved patient's quality of life greatly. 2. Total hip replacement has higher recovery rate of hip function, less long-term postoperative complications, and is the preferred method of artificial hip replacement, even for elderly patients if in better health conditions, have longer life expectancy, or with larger exercise-load. 3. Bipolar femoral head replacement is a more suitable method for elderly patients who are in worse health conditions, with basic diseases, with smaller exercise-load, or with hip dysfunction before injury, because it has advantages in little trauma, less intra-operative blood loses, less operative time, less cost of hospitalization etc.