Artificial Femoral Head Replacement And Total Hip Arthroplasty For The Treatment Of Femoral Neck Fracture In The Elderly

Objective: To follow up the use of artificial femoral head replacement(HA)and total hip arthroplasty(THA)in the treatment of senile unstable femoral neck fractures.The best surgical method for femoral neck fractures.Methods: Eighty patients undergoing artificial femoral head replacement and total hip replacement at the Department of Orthopaedics,Affiliated Hospital of Yan’an University from February 2014 to February 2017 were selected.There were 40 patients in the HA group,including 10 males and 30 females.aged 65 to 88 years,mean age 72.41±4.61 years.The causes of injury were 26 cases of slipping injuries,6 cases of car accident injuries,5 cases of fall injuries,3 cases of other injuries,and Garden classification: 17 cases of type III,IV Type 23 cases.Including 40 patients in the THA group,including 14 males and 26 females,aged 65 to 85 years,mean age 71.23±4.21 years.The causes of injury were 27 cases of slipping injuries,5 cases of car accident injuries,and 4 cases of fall injuries.Injury occurred in 4 cases.Garden classification included 10 cases of type III and 30 cases of type IV.The operative time,intraoperative blood loss,length of hospital stay,hospitalization cost,early postoperative complications,and postoperative 1 year hip rate Harris scores of the two groups were compared and statistically analyzed.Results: The operative time,intraoperative blood loss,hospitalization cost,and P value of the Harris score for one year after surgery were all <0.05,which was statistically significant.The operation time of the HA group was(66.4±3.6)min shorter than that of the THA group(87.2±8.5)min;intraoperative blood loss(186.4±30.5)ml in the HA group was lower than that in the THA group(343.9±40.1)ml;hospitalization expenditure in the HA group was(3.7±0.6)ten thousand lower than that in the THA group(5.2±0.7)ten thousand;Harris group excellent rate of Harris score after surgery in the group was lower than the THA group.The P value of early postoperative complications and length of stay in both groups was >0.05,which was not statistically significant.Conclusion: 1.Injury of femoral neck fracture in the elderly(Garden III,IV type),artificial joint replacement surgery has a good clinical efficacy.2.HA has the characteristics of less trauma,shorter operation time,less intraoperative blood loss,and low cost.It is applicable to patients with poor general condition,large physical age,short life expectancy,multiple comorbidities,and poor economic conditions.3.THA has the characteristics of better postoperative joint function recovery,less long-term complications,long service life,and high cost,and it is suitable for young patients who have a small physiological age,long life expectancy,and good economic conditions.4.Many clinical patients do not choose the THA that suits them because of poor medical insurance and economic conditions.Instead,they choose to spend less HA,which should attract the attention of the country and society.5.The specific program choices for HA and THA should be determined based on preoperative evaluation,intraoperative indicators,postoperative complications,postoperative quality of life and function,and medical insurance and economic conditions.