Multi-disciplinarily comprehensive therapy based on femoral head arthroplasty for old femoral neck fracture in the elderly

Abstract

Objective To investigate the effect and safety of comprehensive therapy based on femoral head arthroplasty in treating old femoral neck fracture in the elderly complicated with other severe basic medical conditions. Methods Thirty-six elderly patients with old femoral neck fracture were treated with femoral head arthroplasty. Mean age of the patients was 78.2 years, and mean duration since injury was 13.7 months. All the patients had at least one severe basic medical problem. Perioperative complications were retrospectively analyzed, and function of hip joint was evaluated 6 months after operation. Results One patient died because of severe pulmonary infection, while 16 electrolyte imbalance, 7 hypotension, 4 arrhythmia, 2 acute heart failure and 1 acute kidney injury were cured in the rest 35 patients. Harris hip score of the 35 patients increased from (22.0±6.8)points pre-operatively to (69.2±10.8)points 6 months post-operatively (P<0.01). Conclusions Comprehensive therapy based on femoral head arthroplasty is effective for old femoral neck fracture in the elderly suffering severe underlying diseases. Early treatment, perfect pre-operative preparation, correct manipulation and appropriate perioperative management play important roles. Key words: Arthroplasty, replacement, hip; Femoral neck fractures; Fracture healing