The Curative Effect Analysis Of Lengthened Femur Prosthesis In The Treatment Of Elderly Patients With Femoral Neck Fracture

Objective:To analyze the clinical curative effect of standard and lengthening proximal femoral prosthesis in the treatment of elderly femoral neck fractures.Methods:We selected retrospectively121femoral neck fracture cases (≥80years old) with artificial femoral head replacement from Jun.2006to Jan.2010in the Affiliated Hospital of Yanbian University. Divided into lengthening proximal femoral prosthesis group58cases and standard handle group (control group)63cases. Then according to the criterion, we research50lengthened artificial femoral head replacement patients:male23cases, female27cases, age80-102years old, mean age (88±8.4) years old and50standard handle hemiarthroplasty group patients:male18cases, female32cases, age80-106years old, mean age (88±8.7) years old. The selection of lengthen artificial femoral prosthesis is according to the preoperative X-ray measurement of the bow angle of femur and the distance between the predetermined cutting point of femoral neck and the femoral angle of anterior arch top. The selection of standard handle group is according to the medullary cavity of the medullary cavity at the top of arch angle on the femoral position X-ray. Standard handle group routine standard handle artificial femoral head replacement. On0.5-4years after the surgery, we evaluated the hip joint function on lengthened artificial femoral head replacement group and standard handle hemiarthroplasty group respectively with the Harris scoring system,In addition, we contrast the osteolysis by the Delee-Charnley partition according to the acquired image data, All the above data used SPSS13.0statistical software for statistical analysis.Results:All patients were followed up,1case of the long stem group died from pulmonary heart disease after2years,1case of standard handle group died frommyocardial infarction after2years,1case died for cerebral hemorrhage after3years, other cases obtained the effective0.5-4years follow-up. There were no significant differences in age, gender, garden somatotype and preoperative complications between the two groups(p>0.05). There was no difference in nearby postoperative(p>0.05), but the postoperative complications rates in0.5-4years were significantly different (p<0.05). According to the last follow-up imaging data of patients, refer to the Delee-Charnley partition, the osteolysis between the two groups has statistically significant differences (p<0.05). According to the results of the evaluation on the hip function by Harris score:after0.5-1year, the function of hip joint between the long stem group and standard handle group is similar, there is no statistical significance between them (p>0.05,). But after2-4years, the the function of hip joint in the long stem group is better than the standard handle group,there is a statistically significant differences between them (P<0.05).Conclusion:1. Lengthened artificial femoral head replacement has better biomechanical stability than the standard handle hemiarthroplasty,can significantly reduce the thigh pain, prosthesis loosening and other complications in2-4years, but there is no significant difference in0.5-1year after operation.2. The long-term effects after4years between the lengthened artificial femoral head replacement and standard handle hemiarthroplasty need further study.