Comparative Research Of Different Types Of Hip Replacement To Treat Unstable Femoral Neck Fracture In Elderly

Entering an aging society,the incidence of femoral neck fracture is also increased year by year in our country.Due to the prevalence of osteoporosis and other internal disease in the elderly,more and more scholars begin to pay more attention to the particularity of femoral neck fracture.Internal fixation is no longer the only choice to treat the elderly femoral neck fracture.That the artificial joint replacement should be a good treatment of femoral neck fracture in aged patients has been received by more and more scholars.Although the bipolar artificial femoral head replacement(BFHR)has become a routine selection to treat femoral neck fracture in elderly,the mainstream view still consider that the total hip replacement(THR)is the first choice for these patients.But THR means much more wounded,it’s just suitable for stronger pateints.And in our research,THR does not indicated obviously advantages.In this study,we reviewed the clinical datas and follow-up scores of two groups patients that undergoing THR and BFHR.To discuse the feasibility and advantage of BFHR.Methods:130 elderly patients with femoral neck fracture of Garden Ⅲ、Ⅳtype were chosen in the period from Jan 2007 to March 2015 in our hospital and randomly divided into two groups such as hemi-hip group(62 patients)with cementless hemi-hip replacement operation and total hip group(68 patients)with cementless total hip replacement operation.The?peri-operative indexes such as average operating time,bleeding volum duaring operation,total blood loss and hospital stays were compared.The postoperative complications include pneumonia,lower limb thrombosis,urinary system infection,hip pain,prosthetic loosening and acetabular?wear??of both groups were compared.The Harris scores were followed for 1 year,3 years and 5 years,and the differences in the twogroups were calculated.Results :The operation time,bleeding volum duaring operation and total blood loss of hemi-hip group was significantly better than total hip group(p<0.05).There was no significant difference in the hospitalization time between 2 groups(p>0.05).There was no significant difference in the excellent and good rate of Harris hip function score in 1-year,3-year and5-year follow up after operation between these 2 groups(p>0.05).The postoperative complication incidence was no significantly differenc between these 2 groups(p>0.05).Conclusion :Two kinds of operation both are effective treatments of unstable femoral neck fracture in elderly,recent and medium-term follow-up results were satisfied.BFHR means shorter time of the operation and lesser operative trauma,and more patients were suitable to be operated.The recent and medium-term follow-up results of BFHR group were equal to the THR group’s,and the rate of complications was no obviously increased.BFHR can be one of the first choice to treat unstable femoral neck fracture.