Outcome Analysis For The Undisplaced Femoral Neck Fractures In Advanced Age Treated With Internal Fixation And Hemiarthroplasty

Objective To analyze the clinical result of using internal fixation and hemiarthroplasty for the treatment of the undisplaced femoral neck fractures in advanced age.Methods 63 consecutive patients who were over 75 years older with the undisplaced femoral neck fractures(Garden 1 and 2) had been treated surgically from September 2009 to May 2014 and 63 cases were followed up. The retrospective study included 21 male and 42 females. Two groups were devided on basis of the different operation methods. Twenty-six patients were treated by internal fixation with an average age of 83.9 years(internal fixation group,IF group)and thirty-seven patients treated by hemiarthroplasty with an average age of 82.1 years(hemiarthroplasty group, HA group).Clinical outcomes including operation time, blood transfusion, major complication,reoperation rate, mortality, pain visual analog scale(VAS), walking ability index(WAI)and the EQ-5D health states were evaluated.Result At the average 39.9 months follow-up, the operation time and the hospitalization time were shorter in IF group than in HA group. And the blood transfusion was less in the IF group than in the HA group. 2 patients reoperated with hemiarthroplasty due to avascular necrosis and 5 patients were deceased caused by comorbidity in IF group.There were one periprosthetic fracture, one dislocation and five deceased in HA group.There were no obvious differences about reoperation rate and mortality(P>0.05). Patients in HA group had less pain, and higher EQ-5D index score compared to patients in IF group(P<0.05). While there were no apparent differences between the two groups with regard to WAI at the last time follow-up(P>0.05).Conclusion Internal fixation operation was simple, easy to do and had less injury,on the other hand hemiarthroplasty obtained the less pain and better functional results. It’svery important for the choice of operation method to evaluate the whole health status of patients, patient demands and medical level.