Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (53): 8536-8541.doi: 10.3969/j.issn.2095-4344.2014.53.002

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Total hip replacement versus artificial femoral head replacement in repair of femoral neck fracture in the elderly: 18-month follow-up

Sun Hui, Zang Xue-hui, Gao Li-hua, Tan Yong-tao   

  1. Second Department of Orthopedics, Nanhai Hospital Affiliated to Southern Medical University, Foshan 528200, Guangdong Province, China
  • Revised:2014-11-04 Online:2014-12-24 Published:2014-12-24
  • About author:Sun Hui, Master, Associate chief physician, Second Department of Orthopedics, Nanhai Hospital Affiliated to Southern Medical University, Foshan 528200, Guangdong Province, China
  • Supported by:

    the Foshan City Medical Scientific and Technological Project, No. 201308209

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Abstract:

BACKGROUND: It is still controversial whether artificial femoral head replacement or total hip replacement is selected in elderly patients with femoral neck fracture during artificial hip replacement.
OBJECTIVE: To compare the 18-month follow-up outcomes of artificial femoral head replacement and total hip replacement for the treatment of femoral neck fractures in older adults.
METHODS: A total of 70 elderly patients with femoral neck fracture were enrolled in this study. There were 17 males and 53 females, at the age of 60 to 83 years old. There were Garden Ⅲ type and Ⅳ type. According to the type of placement, they were divided into two groups: 39 cases in femoral head replacement group and 31 cases in total hip replacement group. No significant differences in gender, age, fracture type and combined disease constitution were detected between the two groups, showing comparability. X-ray was used to observe replacement effects in both groups. Intraoperative blood transfusion amount, intraoperative blood loss, postoperative drainage, operation time, hospital stay and postoperative hip joint function were comprehensively compared between the two groups.
RESULTS AND CONCLUSION: After 18-month follow-up, X-ray showed that femoral neck fracture reduction and fixation were good, and the prosthesis position was good in both groups. No significant differences in hospital stay and postoperative drainage were detectable between both groups (P > 0.05). Intraoperative blood transfusion, blood loss and operation time were better in the femoral head replacement group than in the total hip replacement group (P < 0.05). The excellent and good rate of hip joint function recovery was significantly higher in the total hip replacement group than in the femoral head replacement group (P < 0.05). These results suggested that functional recover of joints after total hip replacement was better and long-term complications were less in the elderly with femoral neck fracture. Total hip replacement is the first method to treat femoral neck fracture in the elderly. Artificial femoral head replacement with shorter operation time, less bleeding and less amount of blood transfusion is suitable for elderly patients with poor physical conditions, less activities and dysfunction in the affected limb before injury.


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


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Key words: femoral neck fractures, hip prosthesis, arthroplasty, replacement, hip, femur head, aged

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