The Comparison Of The Effect Between Cannulated Compression Screw And Hemiarthroplasty In The Treatment Of Senile Femoral Neck Fracture

Objective:To observe the clinical efficacy of cannulated compression screw and hemiarthroplasty in the treatment of senile femoral neck fractures and to compare and analyze,which is to find a safer and more effective surgical method for femoral neck fractures in elderly patients.Methods:The information of 361 patients with femoral neck fractures was collected from January 2017 to January 2019 in the Department of Traumatology and Orthopaedics,Bethune First Hospital of Jilin University.89 cases were remained after strict screening based on pre-established inclusion and exclusion criteria and were followed up every six months after surgery.Patients range in age from 60-70.The follow-up period ranged from 12 months to 36 months,with an average of 19.5 months.24 patients were lost to follow-up.The remained cases were divided into two groups according to different surgical methods: 30 cases in the cannulated compression screw group and 35 cases in the hemiarthroplasty group.The information about age,sex,fracture side,Garden classification,ASA score,preoperative comorbidities,preoperative waiting time,hospital stay,hospitalization cost,blood transfusion volume,perioperative bleeding volume,operation time,postoperative complications,1-year mortality,1-year reoperation rate,and Harris score(6 months and 12 months)was collected,sorted,analyzed,and summarized.Results:1.The cannulated compression screw group was significantly better than the hemiarthroplasty group in terms of the operation time,hospitalization cost,preoperative waiting time,hospitalization time,blood transfusion and bleeding volume(P < 0.05).2.There was no significant difference between the two groups in terms of preoperative complications,postoperative complications,1-year mortality,and 1-year reoperation rate(P > 0.05).3.The Harris score of hip joint function of the hemiarthroplasty group was higher than that of the cannulated compression screw group at6 months(P < 0.05).but there was no significant difference between the two groups at 12 months(P > 0.05).Conclusions:For elderly patients aged 60-70 years,Cannulated compression screw and hemiarthroplasty are effective measures for the treatment of elderly femoral neck fractures,each has merits and demerits.The patients undergoing hemiarthroplasty could quickly load on the ground after surgery.However,the operation cost,surgical trauma were large.Moreover,Hemiarthroplasty is a final treatment.There was no significant difference in long-term hip function between the two groups.Cannulated compression screw is even better than hemiarthroplasty.Moreover,the operation cost is relatively low,which is easy for patients and their families to accept.Moreover,based on the limited life of joint prostheses,there is a possibility of long-term revision in this age group.Therefore,it is recommended that 60-70 years old elderly patients with femoral neck fractures be treated with Cannulated compression screw.