Comparison Of Different Procedures In The Treatment Of Displaced Femoral Neck Fractures In Middle-aged And Elderly Patients

Objective: To evaluate the clinical outcome of three kinds of surgical operations methods for thedisplaced femoral neck fractures in the middle-aged and elderly patients.Methods: All the 80 middle-aged and elderly patients with displaced femoral neck fractures whohad been treated from January 2006 to June 2009 were reviewed. Of them, 25 cases receivedinternal fixation(IF, Group A); 27 femoral head arthroplasty (FHA, Group B)and the other 28total hip arthroplasty (THA, Group C). Comparisons were made among the 3 groups inhospitalization, operating time, intraoperative bleeding, postoperative complications, andfunctional recovery.Results: The operating time and blood loss in Group C is the most than that in Group A andGroup B. Group A have the most postoperative complication, Group B have the least Harrisscore, Group C have the more pain score than Group B, Group C have the most function scoreand Group B have the least. Statistical analysis showed that there is a significant difference inoperating time, intraoperative bleeding, postoperative complications and postoperative Harrisscore, and no significant difference in the hospitalization ,walking score and motion range.Conclusions: Internal fixation can be applied to patients who are relatively young and active,have good quality of bone and can tolerate ambulation lately; THA is suitable for patients withthe displaced femoral neck fractures of the elderly those who are active, have good generalcondition or have relatively longer life expectancy or preexistent hip diseases. FHA is suitablefor patients who have a poor general condition or have serious medical diseases but can tolerategeneral surgery in preoperative assessment.