| Objective:To retrospectively discuss the clinical efficacy between total hip arthroplasty(THA)and closed reduction cannulated screw fixation in patients with displaced femoral neck fractures from 55 to 65 years of age.Methods:A total of 162 patients diagnosed with displaced femoral neck fractures aged 55 to 65 years were admitted into the First Affiliated Hospital of Dalian Medical University from September 2009 to December 2015.They were eligible for complete follow-up,71 cases of which were retrospectively studied.Follow-up data are derived from the information accessible to the department.According to the different surgical methods,all cases of patients were separated to total hip replacement group(THA group)and internal fixation group(IF group).THA group of 39 cases,included 10 males and 29 females;aged 55-65 years,(59.79 ± 3.17)years on average;all cases were femoral neck fractures below heads,based on anatomical structures;according to Garden Classification:14 cases were typeⅢ,25 cases typeⅣ.IF group of 32 cases,including 12 males and 20 females;aged 55-65 years,(58.38 ± 2.84)years on average;all cases were the same femoral neck fractures below heads,based on anatomical structures,according to Garden classification:18 Cases were typeⅢ,14 cases typeⅣ.All cases were followed up for 12-30 months mean15.14months.Two groups were treated with total hip arthroplasty(biotype)replacement and closed reduction hollow compression screw fixation respectively.Through examining the demographic information of the patients in the database,including preoperative complications,the operative duation,the amount of intraoperative blood loss,the partially weight-bearing time and the length of hospital stay,and the postoperative complications were recorded.The patients were followed up for 3 months,6 months and 12 months for hip function.The clinical efficacy was evaluated with Harris scoring system.All data was submitted into the statistical software,for further statistical analysis in corresponding methodsResults:All the patients were followed up after operation.The data were significantly higher in the THA group than in the IF group(P<0.05).The intraoperative blood loss was significantly larger than that in the IF group(P<0.05)The weight gain of the limb was significantly shorter than that of the IF group(P<0.05).There was no significant difference in the time of hospitalization between the two groups(P>0.05).The incidence of early complications in the THA group was 7.7%,which was significantly lower than that in the IF group(15.6%).There was no significant difference between the two groups(P>0.05);the long-term complication rate was 0.0%(P<0.05).There was no significant difference between the two groups(P<0.05),but there was no significant difference between the two groups(P<0.05).At the last follow-up,the Harris score in the hip was significantly better than that in the IF group(P<0.05),and the excellent and good rate was 94.9%in the THA group,IF group patients 75.0%(P<0.05).Compared with IF group,Harris score of THA group was significantly higher than that of IF group(P<0.05)at 3 months,6 months and 12 months after operation.Conclusions:1.Artificial total hip arthroplasty requires higher of the general condition of patients,but its advantage is to allow patients for early-staged partially weight-bearing for corresponding functional exercise,which can give patients better postoperative hip function restore.2.Closed reduction and internal fixation with cannulated compression screw is relatively simple,for short operation time and less traumatic,but the limb can not be for long-time weight-bearing as its corresponding functional exercise.3.For the displaced sub-types of femoral neck fracture,55-65 years of age in patients of this age,it is recommended that total hip arthroplasty should be firstly considered for this group of patients. |
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