Clinical Analysis Of Total Hip Replacement And Artificial Bipolar Femoral Head Replacement In The Treatment Of Senile Femoral Neck Fracture

Objective Retrospectively analyze the curative effect of total hip arthroplasty and artificial bipolar femoral head replacement in the treatment of patients over 70 years old with femoral neck fractures to guide the choice of clinical treatment.Methods Cases of patients with femoral neck fracture treated by hip arthroplasty from January 1st 2015 to January 1st 2018 were collected in the first affiliated Hospital of xxxx University.According to the inclusion criteria,all of the 64 cases were significantly displaced femoral neck fractures(Garden type III,IV),including 20 males and 44 females.According to the operation mode of arthroplasty,the patients were divided into two groups: total hip replacement group(30 cases)and artificial bipolar femoral head replacement group(34 cases).There was no significant difference in analyses of sex,age,fracture classification,combined disease and the statistical score in American Society of Anesthesiologist(ASA),which reveals comparability.The duration of hospitalization,operative time,blood transfusion,blood loss,postoperative drainage,perioperative infection and mortality were compared between the two groups.The complications of joint replacement were observed by X-ray,and the hip joint function was evaluated by Harris score in the last follow-up.Results After 6-36 months follow-up studies it shows that none of the patients showed signs of subsidence or loosening of the artificial hip prosthesis.Dislocation of the hip occur in two patients in the total hip replacement group in one month after operation due to improper posture.The function of hip joint recovered well after reduction.In the artificial bipolar femoral head replacement group,periprosthetic infection occur in one patient in 3 weeks after operation and recovered well after the first stage debridement.Dislocation of the joint happened in another patient in 2 months after primary hip arthroplasty,and the hip joint function had recovered well after reduction.There was no significant difference in the statistical score in American Society of Anesthesiologist(ASA)and hospitalization time between the two groups.(P > 0.05),but the proportion of ASA Ⅲ patients in the bipolar artificial femoral head replacement group was significantly higher than that in the total hip replacement group.During operation time,blood transfusion,blood loss and postoperative drainage were compared between the two groups.The artificial bipolar femoral head replacement group was better than the total hip replacement group(P < 0.05);There was no statistical significance in the incidence of postoperative complications in the two groups after joint replacement.The superior rat of hip joint Harris score in total hip replacement group is better than that in artificial bipolar femoral head replacement group.(P < 0.05)。Conclusion Total hip arthroplasty has the advantages in recovery from hip joint function and low rate of intermediate and long-term complications in the treatment of elderly patients with femoral neck fracture,which is the best choice for the treatment of senile femoral neck fracture.Artificial bipolar femoral head replacement has the advantages in short operation time,less trauma,less blood loss and so on.It is suitable for the elderly patients with poor systemic condition,complicated internal diseases,high anaesthetic risk and less activity.