Total hip arthroplasty versus hollow screw fixation for the repair of femoral neck fractures in the middle-aged and elder patients: hip function

doi:10.3969/j.issn.2095-4344.2015.35.002

Abstract

Abstract:

BACKGROUND: The repair method of femoral neck fractures included internal fixation and hip arthroplasty. The selection of repair methods is affected by many factors, such as age, condition of patients, and own physical condition. The selection of repair methods for femoral neck fractures is always controversial.
OBJECTIVE: To compare the hip function and prognosis of elderly patients with femoral neck fractures after total hip arthroplasty and hollow screw fixation.
METHODS: 140 patients aged less than 60 years, who accepted treatment in Rizhao Hospital of Traditional Chinese Medicine from April 2012 to February 2014, were selected. They were randomly divided into replacement group and fixation group (n=70). Patients in the replacement group received total hip arthroplasty, and patients in the fixation group received hollow compression screw fixation. Harris score of the hip, complications and satisfactions of the hip were observed, compared and analyzed between the two groups at 1 month post surgery.
RESULTS AND CONCLUSION: The excellent and good rate of Harris score at 1 month post surgery was significantly higher in the replacement group (90%) than in the fixation group (63%) (P < 0.05). The incidence of complications was significantly lower in the replacement group (6%) than in the fixation group (29%) (P < 0.05). The satisfaction was significantly higher in the replacement group (93%) than in the fixation group (79%) (P < 0.05). These results verify that the application of total hip arthroplasty for middle-aged and elder patients with femoral neck fracture has a rapid recovery on joint function, has fewer complications, and is suitable for patients who pursue high-quality survival activities. Cannulated compression screw fixation is suitable for middle-aged and elder patients with good quality of preoperative bone.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Arthroplasty, Replacement, Hip, Internal Fixators

CLC Number:

R318

Lin Qing-bo. Total hip arthroplasty versus hollow screw fixation for the repair of femoral neck fractures in the middle-aged and elder patients: hip function[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5583-5587.

Figures/Tables 6

References

[1] Armstrong JC, Nichols BE, Wilson JM, et al. Spinal cord injury in the emergency context: review of program outcomes of a Spinal cord injury rehabilitation program in Spri Lanka.Confl Health. 2014;8(1):4.
[2] 尚松,蒋赞利.股骨转子间骨折内固定失败的相关危险因素分析[J].东南大学学报:医学版,2013,32(3):324-326.
[3] 吴冰,熊发明,许宁宁.股骨转子间骨折髓内固定失败的影响因素研究[J].海南医学,2014,25(11):1597-1599.
[4] 李仁斌,林焱斌,庄研,等.股骨近端螺旋刀片抗旋髓内钉治疗股骨转子间骨折的并发症原因分析[J].中国骨与关节外科,2012, 5(6):466-470.
[5] 刘明忱,史秀梅,刘德辉.三维锁定斜孔钢板在股骨转子间骨折内固定失败髋内翻二次矫形术中的临床应用研究[J].中国骨与关节损伤杂志,2008,23(5):434-435.
[6] 苏树娟,李晓娟.老年股骨骨折患者预防压疮的护理[J].广东医学,2012,33(2):295-296．
[7] 章柏平,卢海峰,汤善华.Gamma钉和动力髋螺钉内固定治疗股骨转子间骨折临床疗效比较[J].临床骨科杂志,2012,15(1): 73-75.
[8] 陆骅,蒋雷生,沈雷,等.Gamma钉治疗股骨转子间骨折后髋内翻及拉力螺钉切割脱出的原因与预防[J].中华创伤骨科杂志, 2007, 9(1):10-13.
[9] Lin PC, Chang SY. Functional recovery among elderly people one year after hip fracture surgery.J Nurs Res.2004;12(1): 72-82.
[10] Zhu QL, Yan MH, Zhao LL, et al. Analysis of treatment of osteoporotic intertrochanteric fracture of femur with the locking compression plate (LCP). Zhongguo Gu Shang. 2011; 24(5):378-381.
[11] 许斌,刘月驹,李智勇,等．股骨颈骨折不愈合高危因素的回顾性研究[J].中华创伤杂志,2012,28(12):1083-1087．
[12] 卢华定,董云旭,温晓粤,等. 空心加压螺钉治疗股骨颈骨折疗效分析[J].中国骨伤,2011,24(4):315-318.
[13] 邓建龙,王剑敏,张茗慧,等.股骨近端防旋髓内钉治疗不稳定转子间骨折[J].实用骨科杂志,2012,18(1):55-57.
[14] 阎戈,王愉思,徐勇强,等.全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的临床对照观察[J].中国医药导报,2012, 9(5):164-165.
[15] 曹前来,王良意,杨海涛,等.闭合复位微创内固定治疗青壮年股骨颈骨折[J].中华创伤杂志,2011,27(10):929-932.
[16] 索南昂秀.人工股骨头置换与动力髋螺钉内固定治疗老年股骨转子间骨折的疗效比较[J].中国老年学杂志,2012,32(16): 3568-3569.
[17] 阮文东,王沛,雪原,等.骨质疏松骨折后再骨折的临床风险因素[J].中华骨科杂志,2011,31(7):789-793．
[18] Dai Z,Li Y,Jiang D.Meta-analysis comparing arthyroplasty with internal fixation for displaced femoral neck fracture in the elderly. J Surg Res. 2011;165(1):68-74．
[19] 叶承锋,孙洪亮,赵乃吴.滑动加压鹅头钉治疗股骨转子间骨折术后髋内翻原因分析[J].广西医学,2003,25(1):147-148.
[20] 谢业东,江庭彪,粱科友.高龄股骨转子间骨折术后的髋内翻浅析(附38例分析) [J].广西医学,2001,23(6):1485-1486.
[21] 齐新德.全髋关节和人工股骨头置换术治疗老年股骨颈骨折的疗效分析[J].中国医药导报,2011,8(7):147.
[22] 黄彦,廖壮文,范子文.青年老年股骨颈骨折患者生物型全髋关节置换术的中期临床疗效[J].广东医学,2011,32(13): 1693-1695.
[23] 王鑫,张勇,张华,等.转子间截骨旋转填塞治疗股骨转子间骨折术后髋内翻[J].四川医学,2012,33(3):450-452.
[24] 王亦璁.骨与关节损伤[M].3版.北京:人民卫生出版社,2001:866.
[25] 殷小军,周正明,顾家烨,等.股骨转子间骨折内固定术后发生髋内翻的相关因素分析[J].中华创伤骨科杂志,2014,16(9):809-811.
[26] 周强,陆骅,俞思明,等.动力髋结合转子稳定钢板与Gamma钉内固定治疗股骨转子间骨折的比较[J].中国组织工程研究,2014, 18(9):1441-1446.
[27] 唐虎子,刘小卫,张立全.动力髋治疗股骨转子间骨折后髋内翻 18例分析[J].中国误诊学杂志,2009,9(1):207-208.
[28] 刘鹄,杨睿,沈慧勇,等. 空心钉正三角形与倒三角形排列方式治疗股骨颈骨折的疗效比较[J].中华创伤骨科杂志,2012,14(8): 726-728．
[29] Siwach RC,Rohilla R,Singh R,et al. Radiological and functional outcome in unstable,osteoporotic trochanteric fractures stabilized with dynamic helical hip system.Strategies Trauma Limb Reconstr. 2013;8:117-122.
[30] 周建生,王志岩,丁海单,等.单头与双头螺纹空心钉固定治疗股骨颈骨折术后并发症发生率的比较[J].中华创伤骨科杂志, 2013, 15(11):967-971.
[31] Namdari S,Rabinovicb R,Scolaro J,et al. Absorbable and non-absorbable cement augmentation in fixation of intertrochanterlc femur fractures:systematic review of the literature. Arch Orthop Trauma Surg. 2013;133:487-494.
[32] 周锦春,郭敦明,王青,等.股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死多中心多因素相关分析[J].中华骨科杂志,2013, 33(5):549-554.