A Comparative Study on the Efficacy of Different Surgical Timing of Arthroplasty for the Treatment of Femoral Neck Fractures in the Elderly

Background : The incidence of femoral neck fractures in the elderly is increasing due to global population aging, posing a significant public health challenge. The optimal timing for surgical intervention remains controversial. To determine if early surgical intervention reduces complications and enhances therapeutic efficacy in elderly patients with femoral neck fractures undergoing hip arthroplasty. Methods : A cohort study was conducted on 173 elderly patients with femoral neck fractures who underwent Hip Arthroplasty from 2023 to 2024. Patients were divided into two groups based on the time from injury to surgery: the early group (80 patients admitted within 48 hours of injury and underwent emergency surgery) and the late group (93 patients admitted after more than 48 hours and underwent elective surgery). Data on operation duration, intraoperative blood loss and transfusion volume, perioperative infection indicators, hospital stay and cost, postoperative ICU admission, Harris score, and FJS score were collected. Results : The early group had longer operation duration, higher intraoperative blood loss and transfusion volume, but these differences were not statistically significant. The early group had significantly shorter hospitalization time (11.51 ± 2.556 vs. 16.00 ± 3.330 days), lower hospitalization cost (43047.84 ± 7093.890 vs. 46102.83 ± 7075.180), and lower postoperative complication rate (28.92% vs. 46.24%) compared to the late group. The Harris score for hip function at 1 month (76.660 ± 3.142 vs. 73.371 ± 3.387) and 3 months (83.402 ± 2.352 vs. 82.660 ± 2.169) postoperatively, and the joint amnesia score at 1 month postoperatively (61.052 ± 9.271 vs. 54.533 ± 11.560) were higher in the early group, with statistically significant differences. Conclusions : Early surgery can faster functional recovery in the early postoperative period, but there is no significant difference in long-term prognosis. The overall condition of the patient should be comprehensively considered, and surgery should be performed as early as possible after optimizing the patient’s overall condition. Clinical trial number: not applicable