The Curative Effect Contrast between the Percutaneous Hollow Compression Screw Internal Fixation and the Prosthetic Replacement for Joint in the Senile Osteoporosis Femoral Neck Fracture
|School||Dalian Medical University|
|Keywords||osteoporosis femoral neck fracture surgical treatment complication|
Objective: Through analyzing the therapeutic effect of various operation patterns in older osteoporotic femoral neck fractures, discuss how to choice the operation pattern.Methods: 120 cases of older osteoporotic femoral neck fracture in Dalian medical university from 2006 to 2011,including 54 male cases and 66 female cases, age from 65 to 85and average age is 71.There are 42 cases of under head type,50 cases of jugular type,28 cases of basal type,these cases were separated into 2 groups:percutaneous hollow compression screw internal fixation, prosthetic replacement for joint, record the operation time, peri-operative bleeding, postoperative load time,did built-in thing was strong or cutting femoral neck, complicating diseases and whether operation again and so on. Took statistical analysis and took Harris rating criteria for evaluating the hip function.Results: All the cases for 0.5 to 5 years of follow-up, through comparing the operation time, peri-operative bleeding, postoperative load time,built-in thing strong or mobilize and postoperative joint functional score in two groups of patients above, analyzed in SPSS18.0,conclusion is: the operation time in the group of percutaneous hollow compression screw internal fixation is minimum, the difference is significant in statistics(P<0.01);The peri-operative bleeding in 2 groups is: percutaneous hollow compression screw internal fixation is minimum, and the difference have statistical significance(P <0.01). And the postoperative load time in the group of percutaneous hollow compression screw internal fixation is the longest (P<0.01).In the group of percutaneous hollow compression screw internal fixation, 16 cases have complications of lower limbs of deep vein thrombosis (DVT), lung and urinary tract infection, the percentage is 40%; In the 80 cases of prosthetic replacement for joint , 6 cases appear afore-mentioned symptoms, the percentage is 7.5%.Through the analysis of SPSS18.0,concluded that:P <0.05, the difference have statistical significanc.4 cases in the group of percutaneous hollow compression screw internal fixation appear fracture nonunion, 12 cases appear femoral head necrosis, 20cases appear retreat screw or cutting femoral neck during in or leave hospital, all of these cases take total hip replacement again, the excellence rate of this group is 37.5%.In the group of prosthetic replacement for joint, 3 cases appear joint pain because of acetabulum abrade, 1 case appear artificial femoral handle wear through femur, these 4 cases take total hip replacement again, 1 case appear joint dislocation after operation, improve and discharge from hospital after taking restoration and lying in bed, the excellence rate is 82.5%,the difference is making sense in statistics, the forward effect of the artificial total hip replacement would be best.Conclusions: In order to reduce the complications, enhance the joint function and the quality of life of patients, and reduce the possibility of reoperation, the patients of senile osteoporotic femoral neck fractures and in the permission of life expectancy and systemic situation, should take the prosthetic replacement for joint as far as possible.