Early efficacy of percutaneous assisted joint capsule approach for femoral neck fracture in elderly patients

doi:10.3877/cma.j.issn.1674-134X.2019.03.004

Abstract

Abstract:

Objective

To explore the feasibility and early efficacy of supercapsular percutaneously-assisted total hip (SuperPATH) minimally invasive approach for the treatment of femoral neck fractures in the elderly with primary artificial femoral head replacement.

Methods

From October 2015 to November 2016, the Orthopedics Department of Yizheng People’s Hospital strictly followed the inclusion and exclusion criteria for the elderly femoral neck fractures. The SuperPATH minimally invasive approach was used for the first artificial femoral head replacement, and 21 patients were included. They were five males and 16 females, six cases in left hip and 15 cases in right hip. The mean age was (74±9) years. The length of incision, operation time, intraoperative blood loss and complication were observed. The hip function was evaluated by hip joint Harris scores before the operation, three days and three months after operation. The measurement data were observed by W test to see whether the data was normally distributed. The hip joint Harris score was analyzed by repeated measures analysis of variance, and the t test was used to compare the two groups.

Results

Twenty-one patients were followed up for three to six months.The average length of the incision was (7.0±1.5) cm, the mean time of hospitalization was (9.6±1.8) d, the average operation time was (61±13) min, the average intraoperative blood loss was (138.7±30.5) ml. The average activity time was (2.4±0.8) d. No serious complications such as skin necrosis, infection, fracture, DVT, joint dislocation and unequal length of the lower limb occurred during the follow-up period.The mean Harris score of the affected hips three days after operation(67. 3±6.3) points was significantly higher than the preoperative one(12.1±4.3) points (t=23.132, P<0.05). The mean Harris score of the affected hips six mouths after operation (84.7±4.5) points was significantly higher than that three days after operation (67.3±6.3) points (t=9.075, P <0.05).

Conclusion

SuperPATH minimally invasive approach has remarkable advantages in the primary treatment of femoral neck fractures of the elderly, which is small trauma, small incision, less bleeding, less pain, early ambulation, good patient satisfaction, and less complications such as joint dislocation after operation, and it conforms to the development concept of minimally invasive surgery and rapid rehabilitation surgery.

Key words: Arthroplasty, replacement, hip, Minimally invasive surgical procedures, Femoral neck fractures

Chengdong Zhu, Gaoshan Qiao, Tiansheng Hu, Leyin Zhu, Wencai Yin. Early efficacy of percutaneous assisted joint capsule approach for femoral neck fracture in elderly patients[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(03): 278-283.

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References 20

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时间	疼痛评分	行走评分	功能评分	关节活动度评分	总分
术前	8.9±3.5	1.2±0.6	2.6±1.3	1.6±0.7	12.1±4.3
术后3 d	37.1±5.1^a	13.4±1.5^a	12.3±1.3^a	3.7±0.8^a	67.3±6.3^a
术后3个月	41.3±1.8 ^a，b	30.1±1.7^a，b	15.8±1.1^a，b	4.5±0.3^a，b	84.7±4.5^a，b
F值	329.735	2863.003	837.054	397.657	563.674
P值	<0.01	<0.01	<0.01	<0.01	<0.01

时间	疼痛评分	行走评分	功能评分	关节活动度评分	总分
术前	8.9±3.5	1.2±0.6	2.6±1.3	1.6±0.7	12.1±4.3
术后3 d	37.1±5.1^a	13.4±1.5^a	12.3±1.3^a	3.7±0.8^a	67.3±6.3^a
术后3个月	41.3±1.8 ^a，b	30.1±1.7^a，b	15.8±1.1^a，b	4.5±0.3^a，b	84.7±4.5^a，b
F值	329.735	2863.003	837.054	397.657	563.674
P值	<0.01	<0.01	<0.01	<0.01	<0.01

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