Comparative Study Of The Effect Of Percutaneous Compression Plate And Artificial Femoral Head Replacement On Senile Femoral Neck Fractures

Objective:The clinical effect of percutaneous compression plate(Percutaneous Compression Plate,PCCP)and artificial femoral head replacement(AFHR)in the treatment of femoral neck fractures in the elderly was studied retrospectively.Methods:Data was extracted from the first affiliated hospital of Soochow University,Follow-up was retrospectively conducted during July 2014 and October 2015.Elderly patients with femoral neck fracture were treated with percutaneous compression plate(PCCP group)or artificial femoral head replacement(AFHR group).According to the inclusion and exclusion criteria,a total of 63 patients were included.In PCCP Group(32 cases),male/female=13/19;age74.5±5.2.of the enrolled patients,5 were combined with hypertension,diabetes and other chronic diseases all cases were stable fractures.In AFHR group;male/female=11/20,age 75.6±6.1.3 cases were combined with chronic diseases such as hypertension and diabetes mellitus.According to garden type,all cases were displaced fractures.Statistically,there was no significant difference between the two groups,which was comparable.In this study,we compared two groups of patients from two following aspects:1.perioperative period:operation time,incision length,intraoperative blood loss,post-operative hospitalization time,total hospitalization time,post-operative landing time,postoperative pain degree(VAS score)and postoperative early complications.2.Discharge follow-up:1 month after surgery,3 months after surgery and the last follow-up of hip function(Harris score),3 months after surgery and the last follow-up of daily life ability(ADL score),and long-term postoperative complications.Results:There was no significant difference between PCCP group and AFHR group in perioperative period,post-operative time and postoperative pain level(VAS score)(P>0.05).In addition,PCCP group:surgical incision length 5.8±1.9cm;The intraoperative hemorrhage was 101.2±22.1 ml;The post-operative hospitalization time was 5.5±1.8 days;The total hospitalization time was 11.3±1.5 days;Corresponding to AFHR group:13.5±2.8 cm;204.7±14.3 ml;7.5±2.7 days;13.1±3.4 days,the difference was statistically significant(P<0.05).After the discharge,the hip function score(Harris score)was better than the AFHR group(P<0.05)in the PCCP group for 1 month after discharge.There was no significant difference in hip joint score(Harris score),daily living ability(ADL score)and postoperative long-term complications(P>0.05)after 3 months and the last time.Conclusion:In conclusion,in the treatment of the elderly without displaced femoral neck fracture,PCCP has little trauma,less bleeding and shorter hospitalization time,compared with AFHR,PCCP can provide better early fixation,while long-term efficacy of the two operation methods has no significant difference.Therefore,for the elderly stable femoral neck fracture patients,PCCP is a good choice,and AFHR is a good option for unstable femoral neck fractures in the elderly.