Comparison Of Three Surgical Methods For New Femoral Neck Fractures In The Elderly

Purpose:Analysis and comparison three kinds of surgical operations methodsfor a femoral neck fractures of advanced age, discussing the gains or losses ofeach the type of the method , finding out the best way to cure the person ofadvanced age with a femoral neck fractures, increasing the old man's surviverate and the living quantity after the treatment.Methods :From 1995.5 to 2005.3 ,78 elderly patients of over 65 years old withdisplaced femoral neck fracture (Garden ⅢⅣ) were operated on with AOcompressive cannular (Group A with 33cases) ,FHA(Group B with28cases)and THA(Group C with 17 cases). Proceed as follows two analysis ofcomparison to three sufferers: Hospitalization time ,anaesthesia time,operation time ,transfusing blood capacity ,leading capacity ,functionexamination time and so on. Analysising the postoperationcomplication .Evaluting the function of hip with Harris system.Results :(一)situation around the operationAverage hospitalization time of three teams is 21.5d,13.9d,12.7d, Proceed asfollows two analysis of comparison to three sufferers,diversity between FHAand THA is not marked significance .(t test, p>0.05). There is a markedsignificance among IF FHA THA by analysising the anaesthesia time,operationtime,transfusing blood capacity,leading capacity,function examination time.(ttest, p<0.05).(二) the follow-up result:1.complicationA team: there are 12 cases with postoperation complication(23.5%),There are 6cases with postoperation complication(63.9%) in GardenⅣ(11cases).B team: there are 6 cases with postoperation hip complication(24.0%)C team: there are 2 cases with postoperation hip complication(12.5%)The rate of complication is checking up by X~2: X~2=6.234 r=2 P<0.05,theTHA is the best method of three method for curing the displacing femoralfracture in the elderly. we can say that there is a marked significance betweenthe GardenⅢand GardenⅣin the IF ,because the X2 is 6.234.2. Evaluting the function of hip by Harris scoring system.The rate of the hip function is checking up by X2: X2=7.084 r=2 P<0.05 wecan say that there is a marked significance among three methods, the group C isthe highest rate of the hip function.DiscussionAO compressive cannular,FAH and THA are the valid method for curing thedisplacing femoral neck fracture in the elderly in the world.because person ofadvanced age have the special Skeleton term ,how to choice the best waywhich can increase the old man's survive rate and the living quantity after thetreatment is focus. Through analysising the situation around the operation andthe follow-up result , three method have different gains or losses as follows:1) the situation around the operation: AO compressive cannular is cheaper thanthe others at the same time it with small wound and shorter operate time.The earlier period replies is necessary for femoral blood provide andreconstruction .but there are 84% patients with Different degree osteopenia, sothe stability of IF is not dependable. During the operation ,We must put threeAO bolts in right position of femoral With the triangle shape, in order tostabilize the femoral neck fracture.We must Use again and again the C typearm X light machine to examine positive side to help the surgical operationcomplete, so the operation time and wound is extended. Average hospitalizationtime of IF is the longest than the others. Proceed as follows two analysis ofcomparison to three sufferers,diversity between FHA and THA is not markedsignificance .(t test, p>0.05). There is a marked significance among IF FHATHA by analysising the anaesthesia time,operation time,transfusing bloodcapacity,leading capacity,function examination time.(t test, p<0.05).2) the follow-up result: Though above three covariances analysising the comparison, in the methodof curing displaced femoral neck fracture of advanced age ,the THA is the bestway in increasing function of postoperation ,decreasing the rate ofpostoperation complication; with the developing of Surgical operationtechnique, the operation time and operation wound is lower day by day. Incuring the facture, the A Group's rate of complication is higher than the others,with the increasing the degree enlargement of with the fracture, occurrencerate contain up-trend. In a word, I think that the whole hip jointdisplacement is the excellent way which cures the fresh displaced femoral neckfractures , can effectively increase the rate of survival and the life quantity .