Early curative effects and influencing factors of primary total hip replacement for senile femoral neck fractures

Abstract

Objective To investigate the early curative effects and influencing factors of primary total hip replacement for senile femoral neck fractures. Methods Between January 2013 and May 2015, 116 elderly patients with femoral neck fracture underwent primary total hip replacement. They were 34 males and 82 females, with an average age of 70.2 years. By the Garden classification, we had 23 cases of type Ⅰ, 34 cases of type Ⅱ, 38 cases of type Ⅲ, and 21 cases of type Ⅳ. Their clinical data were statistically analyzed, including gender, age, body mass index (BMI), preoperative concomitant diseases, Garden classification, injury causes, operative indexes, postoperative rehabilitation time, and postoperative complications. Single factor analyses were conducted to find out the relative factors using χ2 test before multiple factors analyses using logistic regression to screen the significant factors influencing hip functional recovery. Results The 116 patients obtained follow-ups for 12 to 23 months (mean, 18.3 months). According to the Harris hip scores for hip function at the last follow-up evaluation, 36 cases were excellent, 52 good, 20 fair, and 8 poor, giving a good to excellent rate of 75.9%. Single factor analyses found that age, BMI, operation time, surgical approach, discrepancy in bilateral lower limb lengths, postoperative analgesia, total blood loss, postoperative rehabilitation time, and postoperative complications were significantly related to hip functional recovery (P<0.05). Logistic regression analyses found that BMI, surgical approach, discrepancy in bilateral lower limb lengths, postoperative analgesia, total blood loss, and postoperative rehabilitation time were the main factors influencing hip function recovery (P<0.05). Conclusions Primary total hip replacement may lead to fine early curative effects for elderly patients with femoral neck fracture. Smaller BMI, minimally invasive approach, less discrepancy in bilateral lower limb lengths, post-operative analgesia, less total blood loss, and longer postoperative rehabilitation time may facilitate hip function recovery. Key words: Femoral neck fractures; Arthroplasty, replacement, hip; Factor analysis, statistical; Elderly