Treatment of femoral neck fractures by total hip replacement and compressed hollow screws In the aged

Abstract

Objective To compare the therapeutic effects of total hip arthroplasty (THA) and compressed hollow screws in the treatment of femoral neck fractures. Methods From January 2002 to June 2008, we treated 193 cases of fresh femoral neck fracture. Of them, 60 were included in the present study. Thirty-three cases were treated by compressed hollow screws (group A), and 24 cases by THA (group B). Their follow-up time ranged from 12 to 56 months. Therapeutic effects were statistically analyzed in terms of time interval from injury to operation, complications, bed-ridden time, and functional recovery. Results By Harris scoring, group A had an excellent to good rate of 85.2% and group B had 93.9%. The com-plications and rate were relatively higher in IF group. There were 3 cases (11.1%) of femoral head necrosis and 1 case of nonunion (3.7%) in group A, while there were 2 cases (6.1%) of prosthesis loosening which were managed by secondary surgery and 1 case (3.0%) of hip dislocation in group B. Conclusions THA and compressed hollow screws are both effective for the aged patients with femoral neck fracture, but their indications should be strictly followed. Compressed hollow screws can also be applied to patients over 70 years old. For patients with large displacement or osteoporosis, THP should be the flint choice. Key words: Femoral neck fracture; Fracture fixation, internal; Arthroplasty, replacement, hip; Aged