Comparison of internal fixation and artificial hip replacement in elderly hip fracture and analysis of factors of postoperative stroke occurrence.

Objective: This study is designed to assess the effect of internal fixation (IF) versus artificial hip replacement (AHR) on stroke during and after hip fracture.

Methods: A total of 120 elderly patients with hip fractures who were treated in our hospital were retrospectively analyzed and divided into an IF group and an AHR group according to the surgical method. Comparisons were made between patients of two groups in general data, intraoperative and postoperative general conditions, hip function scores, and hip joint excellence rate. According to whether or not patients have had a postoperative stroke, they were classified into the occurrence and non-occurrence groups in order to analyze the influence of single factor and multivariate analysis on the postoperative hip fracture of the elderly patients.

Results: All patients were followed up for 12 months postoperatively. In contrast to the IF group, the AHR group showed better intraoperative and postoperative conditions, higher Harris function score, higher hip joint excellent rate, and lower incidence of postoperative stroke (all P < 0.05). In 120 cases of patients, 18 cases of postoperative stroke occurred, with the incidence rate of 15.00 %. The results of the multivariate analysis reflected that the risk factors for postoperative stroke during hospitalization for hip fracture included advanced age, ASA III and above, long-term anticoagulant medication, and IF surgery (all OR > 1, P < 0.05).

Conclusion: Compared with IF, giving AHR treatment to elderly hip fracture patients can considerably optimize the surgical indicators, improve the hip function of elderly patients, and provide better postoperative recovery.