Comparison Of Curative Effect Between Cannulated Compression Screw Internal Fixation And Hemiarthroplasty In The Treatment Of Non-displaced Femoral Neck Fractures In Elderly Patients

Objective: To compare and analyze the effect of cannulated compression screw internal fixation and hemiarthroplasty in the treatment of senile non-displaced femoral neck fracture,and to provide a reference for the selection of surgical treatment methods for senile patients with non-displaced femoral neck fracture.Methods: A retrospective case-control study was conducted to analyze the clinical data of 77 elderly patients with non-displaced femoral neck fracture from January 2013 to December 2015.The patients were divided into internal fixation group(n=31)and hemiarthroplasty group(n=46)according to the selected surgical methods.Cannulated compression screw internal fixation or hemiarthroplasty were performed in the two groups.The following date were compared between two groups,namely,operation time,bleeding volume,length of hospital stay,postoperative partial time of weight-bearing,hospitalization expenses,complications.The postoperative hip joint excellence rate at different stages,VAS score and WAI score at different stages were compared between the two groups.Results:All 77 patients were followed up for 24-60 months,with an average follow-up time of 37.3 months.The operation time,bleeding volume and hospitalization expenses of the internal fixation group were significantly lower than those of the hemiarthroplasty group(P < 0.05).There was no significant difference in the average hospitalization time between the twogroups(P > 0.05).The partial weight-bearing time of patients in the hemiarthroplasty group was earlier than that in the internal fixation group(P< 0.05).There was no significant in the incidence of postoperative complications between the two groups(P > 0.05),but the incidence of postoperative pressure sores in the internal fixation group was significantly higher than that in the hemiarthroplasty group(P < 0.05).The excellent and good rate of hip joint in the hemiarthroplasty group was 97.8% and 95.7% in half year and one year respectively,which were significantly higher than77.4% and 71.0% in the internal fixation group.The excellent and good rate of hip joint in the hemiarthroplasty group at different stages after operation was significantly better than that in the internal fixation group(P < 0.05).The VAS scores of three months,six months and one year after operation in the hemiarthroplasty group were significantly lower than those of the internal fixation group(P < 0.05).The WAI scores of three months,six months and one year after operation in the hemiarthroplasty group were significantly lower than those of the internal fixation group(P < 0.05).Conclusion: Cannulated compression screw internal fixation is relatively simple and less traumatic in the clinical treatment of senile non-displaced femoral neck fracture.However,postoperative partial weight-bearing time after hemiarthroplasty is early,and the early functional recovery is fast.