Two Different Methods Of Total Hip Replacement For Femoral Neck Fracture To Prevent Leg-length Discrepancy

Objective: To discuss the clinical value and accuracy of two different methods in the total hip arthroplasty of femoral neck fracture in preventing leg-length discrepancy.Methods: The elderly patients(over 65 years old)for the first total hip arthroplasty of the femoral neck fracture from 2016.03 to 2017.09 were selected in the joint Department of orthopedics.There were 60 cases,24 men(24 hips),36 women(36 hips),and the average age of 71 years(66 years-75 years old).60 cases were randomly divided into three groups,20 cases in each group.Intraoperative: the length of the lower extremities(the distance of the patella to the tip of the medial malleolus)was compared in group A;in group B,the pelvic anterior and posterior segments were photographed,and the relationship between the center of the femoral head and the apex of the trochanter of the femur was compared to determine the placement of the prosthesis;in group C,the pelvic anterior and posterior segments were taken to compare the relationship between the sciatic nodules and the trochanter of the femur.To decide the prosthesis to be placed.After operation: fifth days after the operation,the patients were lying on the flat bed,the two lower limbs remained neutral,both lower limbs were straightened and the patella was upwards and without adduction abduction.The distance between the healthy side and the anterior superior iliac spine to the medial malleolus was measured to determine whether the limb was short contraction and the degree of shortening,and the average number was measured in a continuous 3 times or 3 times.The length of the affected limb was reduced by the length of the side of the healthy side.The positive number was expressed as the extended limb of the affected side,the zero expression on both sides of the limb was equal,the negative number indicated the limb shortening.The length of the affected limbs and the limbs in all three groups was statistically analyzed by SPSS17.0,and two methods used to prevent the lower limbs were prevented from the operation.The reliability of equal length was analyzed by intraclass correlation coefficient(ICC).Two sample independent t test was used to analyze the data of three groups.Results: Statistical analysis was performed using the data collected after surgery.The vertical distance from the center of the femoral femoral head to the apex of the greater trochanter was used as the standard to determine the placement of the affected limb prosthesis.The postoperative A group's contralateral femoral head went to the tip of the lateral malleolus.The distance data is 656.00mm±52.95 mm,and the distance from the affected femoral head to the external condylar tip is 659.80mm±49.59 mm.There is no statistical difference in the group P>0.05.The vertical distance from the contralateral minor rotor to the ischial tubercle is the standard in the group B.The distance between the femoral head and the lateral malleolus of the B group was 660.10mm±48.97 mm,and the distance from the affected femur head to the external malleolus was 669.45mm±51.89 mm.There was statistical difference in the group.P<0.05.Conclusion: After operation,A group was 15.55 + 2.837 mm,B group 8.85 + 3.376 mm,C group 12.15 + 2.084 mm.The comparison between group A and group C was P < 0.01,indicating that there was a difference between the two groups.The group C was more valuable than the A group,and the A group was compared with the B group in P < 0.05,indicating that there was a difference between the two groups,and the B group had a better reference value than the A group;the B group compared with the C group.