老年股骨颈骨折患者应用牵引床辅助直接前侧入路全髋关节置换术治疗的效果

The Effect of Traction Bed-assisted Direct Anterior Approach for Total Hip Arthroplasty in Elderly Patients with Femoral Neck Fracture

目的探究牵引床辅助直接前侧入路全髋关节置换术在老年股骨颈骨折患者中的应用可行性。方法应用随机抽样的方式选取在本院及合作医院2020年5月-2022年5月进行全髋关节置换术治疗中的92例患者,将其分为对照组和观察组,每组各46例。对照组实施无牵引床直接前侧入路全髋关节置换术治疗,观察组实施牵引床辅助直接前侧入路全髋关节置换术治疗。对比分析两组患者临床指标、术后影像学指标以及髋关节功能。结果观察组患者术前准备时间、手术时间、术中出血量、住院时间等各临床指标均低于对照组(P<0.05);观察组患者股骨假体中心性固定率显著高于对照组(P<0.05),两组患者双下肢长度差值小于10 mm,差异无统计学意义(P>0.05);两组患者术后1周HHS评分差异无统计学意义(P>0.05),观察组患者术后1个月及术后6个月HHS评分显著高于对照组(P<0.05)。结论老年股骨颈骨折患者应用牵引床辅助直接前侧入路全髋关节置换术治疗能够显著改善临床指标、股骨假体中心性固定率和髋关节功能。

Objective:To explore the feasibility of traction bed-assisted direct anterior approach for total hip arthroplasty in elderly patients with femoral neck fracture.Methods:A total of 92 patients who underwent total hip arthroplasty in our hospital from May 2020 to May 2022 were randomly selected,and were divided into a control group and an observation group,with 46 cases in each group.The control group received direct anterior approach for total hip arthroplasty without traction bed,while the observation group received traction bed-assisted direct anterior approach for total hip arthroplasty.Compare and analyze the clinical indicators,postoperative imaging indicators,and hip joint function between the two groups.Results:The clinical indicators such as preoperative preparation time,surgical time,intraoperative bleeding volume,and hospital stay in the observation group were lower than those in the control group(P<0.05);The central fixation rate of the femoral prosthesis in the observation group was significantly higher than that in the control group(P<0.05),and the difference in the ratio of lower limb length between the two groups was less than 10 mm,without statistical significance(P>0.05);There was no statistically significant difference in HHS scores between the two groups at 1 week after surgery(P>0.05).The HHS scores of the observation group at 1 month and 6 months after surgery were significantly higher than those of the control group(P<0.05).Conclusion:The traction bed assisted direct anterior approach total hip arthroplasty can significantly improve the clinical indicators,the central fixation rate of femoral prosthesis and hip joint function in elderly patients with neck of femur fractures.