ABSTRACT
Objective To compare the effect of compression hollow screw fixation,artificial femoral head replacement and total hip replacement in the elderly.Methods From August 2007 to April 2009,152 cases of femoral neck fracture in the elderly were divided into three groups: compression hollow screw fixation group(54 patients,24 males,with an average age of 59.8±5.3 years);artificial femoral head replacement group(48 patients,16 males,with an average age of 65.3±6.7 years);and total hip replacement group(50 patients,18 males,with an average age of 77.3±6.5 years).The evaluation indicators,including the average sugical time,the average amount of bleeding,the average length of stay and the average postopererative bed time,were compared respectively among the three groups.The postoperative evaluation was made according to Harris Score.Results Harris score in the three groups were 21 excellent and 23 good in the compression hollow screw fixation group,with an average score of 80.52±2.70;26 excellent and 14 good in the artificial femoral head replacement group,with an average score of 86.57±1.90;and 42 excellent and 3 good in the total hip replacement group,with an average score of 96.04±2.10.The total hip replacement group was significantly better than the other two groups(H=0.589,F=12.151,Ps＜0.05).The rate of postoperative complications were 25.93%(14/54) in the compression hollow screw fixation group,18.75%(9/48) in the artificial femoral head replacement group and 4.00%(2/50) in the total hip replacement group(H=1.291,P＜0.05).Conclusion Compared among the three surgery,total hip replacement could resume function and improve the quality of life better,with lower rate of complications.However,the surgical injury and the amount of bleeding were largest.Therefore,we suggest selecting appropriate surgery with considering the patient′s age,physical condition,displacement degree of the fracture,et al.in old femoral neck fractures patients.
ABSTRACT
Objective To compare clinical curative effects of two types of compression hollow screws in the treatment of femoral neck fractures. Methods A retrospective analysis was carried out on clinical records of 87 cases of femoral neck fracture from February 1996 to September 2004 treated with two types of compression hollow screws,that is,doubleheaded compression hollow screws(46 cases,Group A) and AO titanium compression hollow screws(41 cases,Group B).Results A follow-up was conducted for 3 months~8 years(mean,4.2 years).No statistically significant differences were observed between the two groups.The intraoperative blood loss was significantly less and the time to bone union was significantly shorter in the Group B than in the Group A(t=5.147,P=0.000;t=5.472,P=0.000).The surgical outcomes were classified as "excellent" in 34 cases,"good" in 8,"fair" in 1,and "poor" in 3 in the Group A,while "excellent" in 37 cases,"good" in 2,"fair" in 2,and "poor" in no cases in the Group B,without statistically significant differences between the two groups in the rate of "good" or "excellent" results(89.1% vs 95.1%,?~2=0.398,P=0.528).No femoral head necrosis or non-union was found in the Group B. Conclusions Both of two types of compression hollow screws have showed advantages of simplicity of performance,minimal invasion,short operative time,reliable fixation,and high success rate,being an ideal option for femoral neck fractures.