人工股骨头置换与全髋关节置换治疗老年股骨颈骨折

Treatment of Femoral Neck Fracture with Hemiarthroplasty versus Total Hip Replacement in the Elderly

目的 评价人工股骨头置换与全髋关节置换治疗老年股骨颈骨折的临床疗效。方法 对 1 34例老年股骨颈骨折行髋关节置换术 ,其中人工股骨头置换 5 5例 ,全髋关节置换 79例。结果 3例人工股骨头置换术后 2年因髋臼磨损、髋关节疼痛明显行髋臼翻修 ,1例全髋关节置换术后半年因髋臼松动行髋臼翻修 ,其余病例均无明显髋部不适 ,髋关节活动良好。结论 老年股骨颈骨折治疗方法的选择取决于患者全身健康状况、术前的生活状态和活动量、骨的质量和年龄等因素。通过严格的术前评估 。

Objective To evaluate selection of treatment methods and clinical effect on femoral neck fracture with hemiarthroplasty versus total hip replacement in the eldly. Methods One hunded and thirty-four cases of femoral neck fracture were treated with hip replacement,55 of 134 cases were treated with hemiarthroplasty and 79 cases with total hip replacement.Results Three cases of hemiarthroplasty were treated with acetabulum revision 2 years postoperatively because of acetabulum wear and obvious hip pain. One case of total hip replacement was treated with acetabulum revision half a year postoperatively for a loose acetabulum. The other cases had no obvious hip discomfort and had a good range of motion in hip joint.Conclusion Selection of treatment methods for femoral neck fracture in the eldly depends on health condition, the life state and activity level preoperatively, bone density and age. By strictly preoperative evaluation, hemiarthroplasty can obtain the same good effect as total hip replacement.