Postoperative quality of life of internal fixation versus hemiarthroplasty for femoral neck fractures in the elderly
10.3969/j.issn.2095-4344.2017.19.001
- VernacularTitle:半髋置换与内固定修复老年股骨颈骨折后的生活质量对比
- Author:
Jun HU
;
Deqiang ZHANG
;
Xin TANG
- From:
Chinese Journal of Tissue Engineering Research
2017;21(19):2953-2960
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: The treatment strategy for femoral neck fractures has not been confirmed, and choosing internal fixation or arthroplasty remains controversial. After internal fixation, the occurrence of bone nonunion and osteonecrosis of femoral head makes its long-term treatment outcomes far from satisfactory. Can we improve the functional recovery through high-quality reduction, accurate fixation and active postoperative exercise? If so, it may be favorable for the elderly with femoral neck fractures, especially for those combined with other serious diseases.OBJECTIVE: To compare the quality of life in the elderly with femoral neck fractures after internal fixation and hemiarthroplasty.METHODS: 148 patients with femoral neck fractures aged more than 60 years old in the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2013 were analyzed retrospectively. The operation time,intraoperative blood loss, hospitalization time, mortality rate, reoperation rate and postoperative quality of life were compared between internal fixation and hemiarthroplasty in the patients with undisplaced femoral neck fractures (Garden type I or II) displaced femoral neck fractures (Garden type III or IV), respectively.RESULTS AND CONCLUSION: (1) Among 148 patients, 137 cases completed follow-up, and the follow-up rate was 92.6%. (2) The operation time, intraoperative blood loss and hospitalization time in the internal fixation group were significantly superior to those in the hemiarthroplasty group in patients with displaced or undisplaced femoral neck fractures (P < 0.05). (3) There was no significant difference in the mortality rate between two groups, and the reoperation rate in the internal fixation groups was slightly higher than that in the hemiarthroplasty group. (4) The Harris and SF-36 scores in both groups were increased with time, and the difference between two groups was decreased with time, which became equal at 2.5 years postoperatively (P > 0.05). Besides, the time of the patients with undisplaced femoral neck fractures in the internal fixation group achieving the same quality of life with the hemiarthroplasty group was earlier than that of displaced ones. (5) These results suggest that internal fixation holds short operation time, simple operation skills and less trauma in the treatment of femoral neck fractures, and with the development of technology, it can achieve the early functional recovery. Thereafter, it is an effective method for senile femoral neck fractures.
