Treatment and efficacy analysis of Garden grade Ⅲ, Ⅳ femoral neck fractures in patients aged 55-65 years
Xu Gaowei, Chen Ting, Zhang Song, Yao Pengfei, Li Chen, Wang Hao, Dong Bin
Department of Orthopedic, the First Affiliated Hospital of Anhui University of Science and Technology(the First People's Hospital of Huainan), Huainan 232007, China
Abstract：Objective To explore the clinical efficiency of total hip arthroplasty (THA) and internal fixation in the treatment of Garden grade Ⅲ-Ⅳ femoral neck fractures in patients aged 55-65 years.Methods The retrospective control study was conducted. A total of 52 cases with Garden grade Ⅲ-Ⅳ femoral neck fractures who visited the First Affiliated Hospital of Anhui University of Science and Technology (the First People's Hospital of Huainan) from June 2015 to January 2019 were recruited to this study. The patients were divided into two groups according to the surgical method applied for treatment, including the internal fixation group (26 cases, 26 hips) and the THA group (23 cases, 23 hips). General data, such as age, sex ratio, traumatic factors, fracture type, duration of operation, intraoperative blood loss, length of hospital stay, visual analogue scale(VAS), and Harris score of hip function, were compared between the two groups.Results No statistically significant differences in terms of age, gender distribution, fracture type, and injury factors, among others (all P values>0.05) were noted between the two groups. All patients successfully completed surgical treatment and were followed up for 1 year. The operative time, intraoperative blood loss, and length of stay in the internal fixation group were lower than those in the THA group, and the differences noted were statistically significant (all P values<0.01). No significant difference in preoperative Harris function and VAS scores was observed between the two groups (all P values>0.05). Intra-group comparison showed that the Harris function (F=213.582, 204.577) and VAS (χ2 =96.376, 86.679) scores of the two groups were significantly different prior to operation and 1 week, 1 month, 6 months, and 1 year after surgery (all P values<0.01). Moreover, differences between postoperative and preoperative time points were statistically significant (all P values<0.01). The Harris scores of joints in the THA replacement group were higher than those in the internal fixation group 1 week, 1 month, and 6 months after the operation, and the VAS scores of the THA group were lower than those of the internal fixation group 1 week, 1 month, and 6 months after the operation; all differences noted were statistically significant (all P values<0.01). No statistically significant difference in Harris function and VAS scores of the hip joint were noted between groups 1 year after surgery (all P values>0.05).Conclusions Patients aged 55-65 years with Garden grade Ⅲ, Ⅳ femoral neck fractures, THA lower than its reduction and internal fixation surgery complications, and can get early rapid rehabilitation, and more worthy of recommendation.
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2020, Vol. 25 
