The short-term follow-up observation of the curative effects of various treatment methods for displaced femoral neck fractures in young-old adults aged 65 to 74 years
10.3760/cma.j.issn.0254-9026.2025.06.021
- VernacularTitle:65～74岁年轻老年人移位型股骨颈骨折不同术式短期随访的疗效观察
- Author:
Xiang LI
1
;
Aiguo WANG
;
Zhe LEI
;
Xiaohua SHI
;
Ze ZHANG
;
Liangyuan WEN
Author Information
1. 郑州市骨科医院下肢骨科Ⅱ，郑州 450052
- Publication Type:Journal Article
- Keywords:
Femoral neck fracture;
Elderly;
Arthroplasty, replacement, hip;
Hemiarthroplasty
- From:
Chinese Journal of Geriatrics
2025;44(6):795-800
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the short-term curative effects of various treatment methods for displaced femoral neck fractures in young and healthy elderly individuals aged 65 to 74 years, while also exploring the surgical treatment options available for this population.Methods:A retrospective analysis was conducted on 159 patients with displaced femoral neck fractures(Garden types Ⅲ and Ⅳ)who were treated at Zhengzhou Orthopedic Hospital from July 2019 to June 2021.Among these patients, 75 were male and 84 were female, with ages ranging from 65 to 74 years, and an average age of 69.1±2.9 years.Patients were categorized based on the treatment method received: the total hip arthroplasty(THA)group comprised 77 cases, the hemiarthroplasty(HA)group included 42 cases, and the internal fixation(IF)group contained 40 cases.We compared intraoperative blood loss, operation time, Harris hip joint function scores one-year post-operation, and the incidence of secondary surgeries across the groups.Results:All 159 patients were followed up for a duration of 36 to 60 months(mean 45.1 months)postoperatively.Intraoperative blood loss was recorded as follows: IF group(19.3±7.0 ml), HA group(303.7±33.8 ml, P<0.001), and THA group(453.6±75.6 ml), with statistically significant differences in pairwise comparisons among the three groups(all P<0.001).The operation times were: IF group(40.7±13.1 min), HA group(53.2±7.5 min), and THA group(96.8±23.6 min), again showing statistically significant differences between each pair of groups(all P<0.001).The Harris hip score at one year postoperatively was(82.1±8.0)points, with an excellent and good rate of 82.4%.Specifically, the THA group scored(82.1±8.1)points with an excellent and good rate of 83.1%; the HA group scored(82.3±7.5)points with an excellent and good rate of 83.3%; and the IF group scored(81.8±8.0)points with an excellent and good rate of 80.0%.No statistically significant differences were observed in the excellent and good rates among the three groups(all P>0.05).A chi-square test performed on the overall postoperative complications among the three groups revealed no statistically significant differences( P=0.115). Conclusions:For relatively healthy elderly patients aged 65 to 74 with femoral neck fractures, hip replacement is not the sole treatment option.Treatment plans should be individualized based on patients' health conditions, transcending age limitations, to effectively address the growing challenges posed by femoral neck fractures in an aging society.
