| Objective:To observe the clinical effects of Bipolar artificial femoral head replacement (BA) and total hip arthroplasty (THA) in the treatment of fresh and displaced femoral neck fractures in the elderly, and analyzed contritely. Methods:Selected 119 cases of fresh and displaced femoral neck fractures in the elderly diagnosed and treated in our hospital between January 2007 and January 2012. Analyzed patients’ data and divided them into BA group (54 cases) and THA group (65 cases) according to the surgery options. Patients in BA group accepted bipolar artificial femoral and patients in THA group accepted total hip arthroplasty. Observed the perioperative indicators, recent indicators of outcome and long-time indicators of outcome, and compared and analyzed statistically. Results:The surgery time of patients in BA group (66.44±9.96)min was shorter than that of patients in THA group(85.30±14.60)min, the inter-group was difference(P=0.005); The blood loss (338.23±18.23)ml in BA group was significantly less than those of patients in THA group (621.28±31.28)ml, the inter-group was differences(P=0.004);and the amount of blood transfusion (292.67±103.52) ml was also less than that of patients in THA group (400.40±99.79) ml,the inter-group was differences(P=0.034);In the observation of recent efficacy after 3 months, the excellent and good rate (94.44%) and complication rate (14.81%) of patients in BA group were not different from those of patients in THA group (95.38%),(16.92%), and the WOMAC score(13.23±3.16),OHS score(18.23±2.39) and SF-36 (90.23±5.28) of patients in BA group were not different from those of patients in THA group(12.48±2.88), (17.28±2.11), (92.23±6.22), which were not statistically significant(P>0.05).In the observation of long-term efficacy of follow-up 2 years, the excellent and good rate of patients in BA group (48.15%) was lower than that of patients in THA group(75.38%), and the complication rate of patients in BA group (25.93%) was higher than that of patients in THA group (13.85%), the inter-group differences were statistically significant(P<0.05). the WOMAC score (18.92±3.28) and OHS score (27.23±4.23) of patients in BA group were higher than those of patients in THA group(13.23±2.03), (14.23±3.53), and the SF-36 score (68.23±4.38) was lower than that of patients in THA group (86.53±5.02), the above inter-group differences were statistically significant (P<0.05). In the 2-year follow-up period, the re-operation or revision rate of patients in BA group (18.52%) was higher than that of patients in THA group (6.15%), the inter-group difference was statistically significant (P<0.05). Conclusion:Both bipolar artificial femoral head replacement and total hip arthroplasty have good recent clinical effect in the fresh and displaced femoral neck fractures. While the former one is of shorter surgery time, less trauma, postoperative faster recovery, especially for elderly patients with severe medical conditions, but it is also of poorer long-term efficacy, more complications, poorer hip function, lower quality of life and higher reoperation or revision rate. Although total hip arthroplasty is of longer surgery time, bigger trauma, more Amount of blood transfusion and slower recovery, it is of better long-term efficacy, fewer complications, better hip function, higher quality of life and lower reoperation or revision rate, which is suitable to patients with good state, long expectable survival, and big activity volume and that is the first treatment choice for fresh and displaced femoral neck fractures in the elderly. |
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