One-stage Artificial Hip Arthroplasty For The Treatment Of Femoral Neck Fracture In The Elderly

Objective:To analysis the relation of clinical efficacy and patient selection,types of prosthetic,fixation methods, operative technique,post- operative complications in one-stage artificial hip joint arthroplasty for femoral neck fracture,from the follow-up this group cases.In order to provide reference for improve the clinical efficacy in artificial hip joint arthroplasty for femoral neck fracture in elderly patients.Methods:Follow-up the Second Affiliated Hospital of Dalian Medical University patients who were treated with artificial hip joint arthroplasty for femoral neck fractures from January ,1995 to January,2002, and count Harris hip scores of postoperative patients with different types of prosthesis, types of fixation methods (with or without cement) with Harris hip scores standard.Results:1.Complication:Following-up the 212 patients,2 cases infection(0.9 %),2 cases prosthesis aseptic looseness (0.9%),2 cases dislocations(0.9%),4 cases deep vein thrombosis(1.9%),3 cases femoral fracture(1.4%).2.The Harris hip scores was 44 scores to 96 scores,average 86.30 scores;114 cases(53.8%) were excellent,65 cases (30.7%) were good;21 cases (9.9%) were medium,11 cases (5.2%) were bad,excellent and good rate were 84.4%.3.Harris hip scores of group femoral head arthroplasty (85.13±7.08 scores)was not significant differences to Harris hip scores of group total hip arthroplasty (85.62±7.23 scores),P >0.05; group bone-cement (85.06±6.21 scores),group cementless (85.34±6.43 scores),grouphybrid(85.92±6.48 scores),three groups no significant differences. 4.X-ray: There were 3 cases affirmation prosthesis aseptic looseness, there were 11 cases uncertain prosthesis aseptic looseness.Femoral:2 cases affirmation,6 cases uncertain; acetabulum:1 cases affirmation, 5 cases uncertain.Conclusion:1.One-stage artificial hip arthroplasty for the treatment of femoral neck fracturein the elderly is effective.2.For eldely with serious medical diseases patients, the best choice is bipolar femoral head replacement. Total hip replacement is mainly used to patients who a longer life expectancy or preexistent joint destruction.3.The bone-cement prostheses is mainly used to patients who have difficulty to use crutches, the poor state of body, serious osteoporosis, the medullary cavity is excessive or low requirement for postoperative activity, and so on. The cementless prostheses is mainly used to patients who have good quality of the bone, a longer life expectancy or large amount of activity.4.Strictly appraising the operative indications, standardizing the operative processes, effectively preventing out of the postoperative complications will remarkable improve the clinical results of hemiarthroplasty for femoral neck fractures.