The Clinical Effect Comparison Study On The Total Hip Replacement And Cannulated Screw Internal Fixation For Curing Senile Femoral Neck Fracture

Objective In order to explore the ideal operation method for treatment of senilefemoral neck fracture, we retrospectively analyzed the two different surgical treatmentof the patient who had been underwent artificial total hip replacement and internalfixation with cannulated screws, through comparative study, to provide a basis for theideal choice of operation method.Methods Patients with a total of64cases of senile femoral neck fracturemethods retrospective study in our hospital from2005February to2011February weretreated respectively with total hip arthroplasty and internal fixation with cannulatedscrews in2kinds of operation mode of the fracture, the patients were divided into THRtreatment group (THR group) and cannulated screw internal fixation treatment group(internal fixation group), THR group of35cases, internal fixation group of29cases. Toobserve everybody the operation time, operation bleeding, hospitalization time, the rateof postoperative complication, the good rate of hip joint function score, the rate of deepvein thrombosis, the rate of postoperative operation.All data were analysed by SPSS11.5software.Results All patients were successfully completed the operation, after operationwere followed up, follow up time was2.1-6.9years, average4.7years. THR groupoperation time and internal fixation group operation time respectively were（93.1±4.7）min and（71.0±4.9）min, the two group has significant difference(t=25.04,p<0.05),showed that THR group operation time is longer than internal fixation group; THRgroup operation bleeding and internal fixation group operation bleeding respectivelywere (485.6±24.5)mL and (215.7±24.7)mL, the two group has significant difference(t=59.963，p<0.05), showed that THR group operation bleeding is more than internalfixation group; THR group hospitalization time and internal fixation group hospitalization time respectively were (20.3±4.9)d and (14.5±3.2)d, there wassignificant difference between the two groups (t=11.302,P<0.05), showed that THRgroup hospitalization time is longer than internal fixation group; the rate ofpostoperative complication of the THR group was14.3%, the rate of postoperativecomplication of the internal fixation group was27.6%, there was significant differencebetween the two groups(x2=4.842,P<0.05), showed that THR group postoperativecomplication rate is lower than internal fixation group; THR group postoperativeoperation rate and internal fixation group postoperative operation rate respectively were14.3%and27.6%, there was significant difference between the two groups(x2=4.842,P<0.05), showed that THR group postoperative operation rate is lower thaninternal fixation group; THR group postoperative good rate of joint function score andinternal fixation group postoperative good rate of joint function score respectively were80.0%and55.2%, there was significant difference between the two groups (x2=9.196，P<0.05), showed that THR group joint function is better than internal fixation group;THR group postoperative deep vein thrombosis rate and internal fixation grouppostoperative deep vein thrombosis rate respectively were8.6%and10.3%, there wasno significant difference between the two groups (x2=0.078，p>0.05), showed that therate of deep vein thrombosis of the two group was no difference.Conclusion Total hip replacement is one of the effective treatment for senilefemoral neck fracture, compared with cannulated screw fixation, artificial total hipreplacement is a bette more ideal operation mode for senile femoral neck fracture.