Effect analysis of artificial joint replacement in treatment of femoral neck fracture with hemiplegia

Objective To analyze the effect of artificial joint replacement surgery in patients with femoral neck fracture associated with hemiplegia. Methods The relevant data of patients with Garden III and IV fractures of femoral neck who were treat with artificial joint replacement from January 2010 to December 2015 were collected. The hospital records and follow-up data were reviewed. All the patients with hip abductor muscle strength greater than grade III had a certain ability to walk before fracture, excluding pathological fractures. Based on the ability of pre-injury ambulatory status, the patients were divided into hemiparesis group and non-hemiparesis group. The age, hospitalization time, operation time, blood loss, perioperative complications, functional exercise for the first time after operation and recovery of activity ability were compared. The measurement data including age, operative time, blood loss, functional exercise for the first time after operation, and hospitalization time were compared using independent sample t-test, and the count data were compared using Chi-square test. Results A total of 121 eligible patients were enrolled in this study, including 31 patients with hemiplegia and 90 patients without hemiplegia. Twenty-five cases in the hemiplegia group and 70 cases in the non-hemiplegia group were followed up. There was no significant difference in age, operation time, peri-operative complications, blood loss, functional exercise for the first time after operation, or early complications between the two groups(all P>0.05). There were significant differences between the two groups in hospitalization time(t=3.8620, P<0.05) and the recovery of the activity ability(χ2=4.6781, P<0.05). Conclusion Artificial joint replacement is an effective treatment in the patients with Garden type III and type IV fractures of femoral neck with hemiplegia, but the patients may have a longer hospital stay and a higher incidence of decreased activity after operation. Key words: Hemiplegia; Femoral neck fractures; Arthroplasty, replacement, hip