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OBJECTIVE: In hemiarthroplasty, the choice of prosthesis is particularly important, which directly affects the success rate of operation and postoperative complications. Hemiarthroplasty can be divided into bipolar hemiarthroplasty and unipolar hemiarthroplasty. This study systematically evaluated the clinical efficacy and safety of bipolar hemiarthroplasty and unipolar hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly so as to provide evidence-based support for prosthesis decision-making in hemiarthroplasty. METHODS: The databases including PubMed, The Cochrane Library, OVID, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were searched to collect clinical randomized controlled trials of bipolar hemiarthroplasty and unipolar hemiarthroplasty for displaced neck femoral neck fractures in elderly patients at home and abroad. The Cochrane Handbook risk assessment tool was used to evaluate the quality of the included studies. The results of the included studies were meta-analyzed by RevMan 5.3 software. RESULTS: (1) Eighteen randomized controlled clinical trials with high quality were included, with a total of 1 988 fractures patients, including 998 cases in bipolar hemiarthroplasty group and 990 cases in unipolar hemiarthroplasty group. (2) There were no statistically significant differences in mortality, dislocation of prosthesis, loosening of prosthesis, local infection, hip pain, general complication, and surgical informations between bipolar hemiarthroplasty and unipolar hemiarthroplasty (P > 0.05). (3) Harris score was higher in the bipolar hemiarthroplasty group than that in the unipolar hemiarthroplasty group (MD=1.77, 95%CI:0.94-2.61, P < 0.001). The rate of acetabular erosion in bipolar hemiarthroplasty group was lower than that in unipolar hemiarthroplasty group (RR=0.25, 95%CI:0.13-0.47, P < 0.000 1). However, two studies have reported that bipolar implants may be more costly. CONCLUSION: Compared with unipolar hemiarthroplasty, bipolar hemiarthroplasty has lower acetabular wear rate and better recovery of hip function in elderly patients with displaced fem-oral neck fracture. However, whether bipolar prosthesis has better economic benefits than uni-polar prosthesis needs further evaluation in the future. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of open and closed reduction and internal fixation with hollow nails on the quality of fracture reduction and hip joint function in patients with displaced femoral neck fractures. Methods: This study is a retrospective study. The clinical data of 98 patients with displaced femoral neck fractures were selected. According to different surgical methods, the patients were divided into group A (n=50, open reduction) and group B (n=48, Closed reduction), compare the good and good rate, fracture reduction quality, hip joint function, perioperative index, postoperative complication rate and secondary operation rate between the two groups. Results: The excellent and good rate of patients in group A was 78.00% (39/50) at 6 months after surgery, which was higher than 58.33% (28/48) in group B (P<0.05). There was no difference between the two groups in postoperative weight-bearing time and intraoperative fluoroscopy time (P>0.05); the operation time and hospital stay in group B were shorter than those in group A, and the amount of intraoperative blood loss was less than that in group A (P<0.05). The Harris scores of hip joint function at 1 month, 3 months, and 6 months after operation were higher than those before operation in the two groups, and group A was higher than group B (P<0.05). There was no difference in the incidence of secondary operations and complications between the two groups (P>0.05). The number of type I and type II cases in group A were more than that in group B, and the number of type III cases was less than that in group B (P<0.05). Conclusion: Compared with closed reduction cannulated screw internal fixation, open reduction cannulated screw internal fixation is more damaging, but its postoperative fracture reduction quality and hip joint function improvement effect is better, and it does not increase the incidence of complications and secondary complications. The incidence of surgery. [ABSTRACT FROM AUTHOR]