Clinical Analysis Of Hollow Compression Screw Fixation And Artificial Femoral Head Replacement In The Treatment Of Elderly Non-displaced Femoral Neck Fractures

Objective:To observe the clinical effect of hollow compression screw internal fixation and artificial femoral head replacement surgery in the treatment of elderly non-displaced femoral neck fractures,so as to clarify the advantages and disadvantages of hollow compression screw internal fixation and artificial femoral head replacement in the treatment of elderly non-displaced femoral neck fractures,and provide clinical basis for future clinical treatment.Method:Patients with non-displaced femoral neck fractures admitted to the Department of Orthopedics and the Second Hospital of Shandong University from May 2015 to may 2020 were selected,and 49 patients treated with hollow compression screws(internal fixation group)and 49 patients with bipolar artificial femoral head replacement(replacement group)were selected in strict accordance with the inclusion criteria and exclusion criteria.The average operation time,intraoperative blood loss,postoperative bed rest time,postoperative imaging results,complete weight-bearing time,partial weight-bearing time,postoperative complications and treatment costs of patients undergoing cannulated compression screw internal fixation and hip replacement were recorded and compared.The hip joint function at different time points after operation were compared between the two groups.Software SPSS 25.0 statistical analysis was used.Result:(1)The average operative time,intraoperative blood loss,and all treatment costs were significantly reduced in patients in the internal fixation group compared with those in the replacement group(P<0.05).(2)There was no significant difference in the Harris hip score and excellent and good rate of hip joint between two groups at 6 months,12 months and 24 months after operation(P>0.05).According to the time sequence,Harris hip score of two groups at 3 months,6 months,12 months and 24 months after operation was significantly higher than that at 6 weeks after operation(P<0.05).The Harris hip score of two groups at 6 months,12 months and 24 months after operation was significantly higher than that at 3 months after operation(P<0.05).There was no significant difference on Harris hip score between two groups at 6 months and 12 months after operation(P>0.05).The Harris hip score of two groups at 24 months after operation was significantly higher than that at 12 months after operation(P<0.05).However,the Harris hip score and hip joint improvement rate in patients in the replacement group 6 weeks postoperative and 3 months after surgery increased significantly compared with the internal fixation group(P<0.05).(3)There was no significant difference in partial weight-bearing time between the two groups of patients(P>0.05);The postoperative bed resting time and complete weight-bearing time were significantly increased in patients in the internal fixation group compared with those in the replacement group(P<0.05).(4)The difference in length of both lower extremities in the postoperative imaging results of patients in the internal fixation group was statistically significant compared with that in the replacement group(P<0.05);There was no statistically significant difference in postoperative reoperation rates between the two groups(P>0.05).Conclusion:Hollow screw internal fixation and artificial femoral head replacement can achieve good treatment results,screw internal fixation technology is simple to operate,surgical safety,good hip function recovery,low treatment cost,in line with the concept of hip preservation,while artificial femoral head replacement can achieve rapid recovery.For elderly patients with non-displaced femoral neck fracture,a variety of factors should be considered comprehensively and appropriate surgical modalities should be selected.