Comparison Between Two Method For Femoral Neck Fractures In Elderly

Objective: To compare total hip replacement and internal fixation in curative effects for the femoral neck fracture in the aged population.Methods: All the 134 old patients with femoral neck fracture who had been treated from June 2000 to June 2007 in our department were reviewed. Of them,69 cases received total hip joint replacement(Group A),65 cases received internal fixation(Group B). The two groups were similar in age, fracture classification, injury time and preoperative health condition. Their average follow up was 46(24-84) months. Comparisons were made between the two groups in operating duration, intraoperative bleeding, hospitalization, ambulation time, postoperative complications and functional recovery.Results: In comparision of the age, the interval from injury to surgery, the proportion of displaced and undisplaced fractures, coexisting disease, duration of the hospitalization, the function comparison of undisplaced fracture between the two groups there were no difference (P>0.05).While in comparision of the operation time [(71.73±13.78 )min in A group,( 58.62±12.24) min in B group],blood loss[(360.50±30.18)ml in A group, (170.38±22.12)ml in B group], ambulation time[ (7.58±3.43) days in A group, (50.47±6.65) days in B group],complications(5.79% in A group, 20.00% in B group), total function(91.30% of good rate and 3.00% of poor rate in A group compared with 75.38% of good rate and 15.38% of poor rate in B group), the function comparison of displaced fracture between the two groups(91.11% of good rate and 2.22% of poor rate in A group compared with 61.11% of good rate and 22.22% of poor rate in B group), there was a significant difference(P<0.05). Conclusions: For elderly femoral neck fracture patients, THR have the advantages of short ambulation time, less postoperative complications and good joint function. THR suitable for those with hip joint osteoarthritis, severe osteoporosis or other serious geriatric diseases and GardenⅢ,Ⅳ-type femoral neck fracture patients. The internal fixation have the advantages of short operation time, low blood loss,low cost, easy to be accepted for patients. Internal fixation suitable for those GardenⅠ,Ⅱ-type femoral neck fracture patients who have good hip joint activities and good bone qualities before injury.For those elderly patients who have serious medical complications, internal fixation may be also the first choice for treatment.