微创直接前入路与后外侧入路行全髋关节置换对股骨颈骨折患者术后平衡功能及髋关节功能的影响

Effects of Minimally Invasive Direct Anterior Approach and Posterolateral Approach of Total Hip Arthroplasty on Postoperative Balance Function and Hip Functional Rehabilitation in Patients with Femoral Neck Fractures

目的探讨股骨颈骨折(FNF)患者采用微创直接前入路(DAA)与后外侧入路(PLA)行全髋关节置换术(THA)的效果.方法选取2020年1月—2021年6月本院收治的FNF患者80例为研究对象,采用随机数字表法将其分为两组,每组40例.对照组采用PLA-THA,观察组采用DAA-THA,比较两组的手术指标,手术前后的疼痛程度、髋关节功能、平衡功能,及并发症发生情况.结果观察组的下床活动时间及切口长度均短于对照组,引流量及出血量均少于对照组,组间差异有统计学意义(P<0.05).术后7 d,两组的疼痛视觉模拟评分均低于术前,且观察组评分低于对照组,组间差异有统计学意义(P<0.05).术后6个月,两组的Harris髋关节功能评分、Berg平衡量表评分均高于术前,且观察组各项评分均高于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率为2.50%,低于对照组的20.00%,差异有统计学意义(P<0.05).结论与PLA-THA比较,FNF患者采用DAA-THA的创伤小、并发症少,可减轻术后疼痛,改善平衡功能,促进髋关节功能恢复.

Objective To investigate the effect of minimally invasive direct anterior approach(DAA)and posterolateral approach(PLA)for total hip arthroplasty(THA)in patients with femoral neck fracture(FNF).Methods A total of 80 patients with FNF admitted to our hospital from January 2020 to June 2021 were selected as the research objects and were divided into two groups by random number table method,with 40 cases in each group.The control group was treated with PLA-THA,while the observation group was treated with DAA-THA.The operation indexes,pain degree,hip function,balance function before and after operation,and complications were compared between the two groups.Results The ambulation time and incision length of the observation group were shorter than those of the control group,and the drainage volume and blood loss were less than those of the control group,and the differences between the groups were statistically significant(P<0.05).At 7 days after operation,the visual analogue scores of pain in the two groups were lower than those before operation,and the score in the observation group was lower than that in the control group,and the differences between the groups were statistically significant(P<0.05).At 6 months after operation,the Harris hip function scores and Berg balance scale scores of the two groups were higher than those before operation,and the scores of the observation group were higher than those of the control group,and the differences between the groups were statistically significant(P<0.05).The complication rate of the observation group was 2.50%,which was lower than 20.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with PLA-THA,DAA-THA can reduce postoperative pain,improve balance function and promote hip joint function recovery in FNF patients with less trauma and fewer complications.