Clinical outcome of enhanced recovery after surgery for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients

Abstract

To analyze and evaluate the clinical outcomes of enhanced recovery after surgery(ERAS) for hemiarthroplasty for the treatment of femoral neck fractures in elderly patients. From January 2015 to December 2016, 466 patients with femoral neck fractures were admitted in our department. Among them, 154 patients were more than 80 years old, with an average age of (83.9±3.2) years old (ranged, 80 to 96 years old), including 27 males and 127 females. According to Garden classification system, 68 cases were type III and others were type IV. ERAS for hemiarthroplasty were performed for all the patients. The time before operation, blood transfusion rate, complications rate, lenth of stay and Harris score system were evaluated. Among 154 patients, 142 patients were followed up, with an average duration of 24.6 months(ranged, 14 to 38 months). Thirty-two patients (20.8%) completed the operation within 48 hours after admission, 67 patients(43.5%) completed the operation within 72 hours after admission, 76 patients(49.4%) discharged within 48 hours after operation, and the blood transfusion rate was 15.9%. One patient was re-hospitalized because of prosthetic dislocation. The re-hospitalization rate was 0.6%. No other patients were re-hospitalized because of superficial or deep infection or periprosthetic fracture. At the latest follow-up, the Harris hip score was 90.2±7.1, 106 patients got an excellent result, 23 good and 9 fair. ERAS for hemiarthroplasty can effectively shorten hospitalization time, relieve pain, reduce blood transfusion rate, reduce postoperative complications, and do not increase the readmission rate of elderly patients with femoral neck fracture, which can achieve good clinical efficacy.