Impact Of Diabetes On The Therapeutic Effect And Prognosisof Femoral Neck Fracture In Different Surgical Methods

Objective:To explore the different effects of diabetes on the femoral neck fracture in each surgical method which provide clinical experience for operating on the patients with diabetes and femoral neck fracture in the future.Methods:The study included 477 femoral neck fracture patients experienced surgical treatment. The patients were divided into groups of internal fixation, total hip arthroplasty, hemiarthroplasty according to surgical methods and each surgical method were divided into diabetic and non-diabetic subgroups. The curative effect and prognosis in diabetic and non-diabetic groups were compared and analyzed by SPSS statistical software.Results:The internal fixation and total hip arthroplasty patients with diabetes were older(P<0.05)than non-diabetic patients,but diabetic subgroups had similar age to non-diabetes in hemiarthroplasty(P>0.05).There was no significant difference in gender, hemoglobin on admission,fracture site, fracture classification and hip fracture history between diabetic and non-diabetic subgroups in each surgical mehtod(P<0.05). The hemiarthroplasty patients with diabetes had a higher bone mineral density value than non-diabetic patients(P<0.01). The diabetic groups had a longer time to surgery and longer post operation hospitalization duration,longer length of hospital stay than non-diabetic groups in each surgical method(P<0.05).Among medical complications before fracture,the diabetic groups had higher hypertension rates than non-diabetic groups in each surgical method(P<0.05),there was significant difference in heart disease rate pre-operation(P<0.05),cerebrovascular disease rate(P<0.05)in diabetic and non-diabetic groups experienced arthroplasty, but there was no significant difference between diabetic and non-diabetic subgroups in internal fixation group(P>0.05). Among perioperative complications,the hemiarthroplasty groups with diabetes had a higher incidence of heart disease than non-diabetic group(P<0.05),the arthroplasty patients with diabetes were more likely to develop gastrointestinal symptoms(P<0.05). At one year,the diabetic groups had similar postoperative activities function, postoperative pain score and postoperative radiographs to non-diabetics in each surgical method(P<0.05).Conclusions:The femoral neck fracture patients with diabetes have longer length of hospital stay and are more likely to develop medical complications before fracture and perioperative complications than non-diabetic groups,and the effects are different in each surgical method. But the diabetic patients have similar postoperative activities function,postoperative pain score and postoperative radiographs to non-diabetics. We should strictly control perioperative blood glucose,strengthen the treatment of medical complications before fracture and perioperative complications, shorten length of hospital stay for patients with diabetes.