人工股骨头置换术治疗股骨颈新鲜骨折的临床评价

A CLINICAL EVALUATION OF ARTIFICIAL FEMORALHEAD REPLACEMENT IN TREATMENT OF FRESHFEMORAL NECK FRACTURE

人工关节置换术是否为新鲜股骨颈骨折的主要治疗方法，尚有不同意见。作者从１９８２～１９９０年住院治疗的４１２例股骨颈新鲜骨折病例中，选择年龄、性别分布、骨折部位、随访时间均相仿的螺纹钉内固定患考７０例，人工股骨头置换术３９例进行回顾分析。发现两组患者的并发症发生率、再手术率、下床活动时间和远期功能评分均无统计学差异，而内固定组的住院时间、手术费用、手术时间、手术创伤和失血量均明显少于股骨头置换组。因此，有效的内固定术仍应作为新鲜股骨颈骨折的首选治疗方法。

Abstract There has heen evoked a clinical controversyas to whetker artificial joint repl acement isthe main method of management of fresh frac-ture or femoral neck.Among the 412 cases offresh fracture of femoral neck that were hos-pitalized between 1982 to 1990,70 cases treat-ed by suhcutaneous screw-threaded pins and 39cases with artificial femoral head replacementin similar age and sex distribution, fracturelevel and follow-up duration were chosen for aretrospective analysis. It was found that thecomplication rate,re-operation rate,leavingbed tlme and late function score between thetwo groups showed no stastistical differnce,but the time of hospitalization. operation cost,operation time,operative trauma and amountof hlood loss of the internal fixation groupwere obviously less than that of the femoralhead replacement group. Consequently ,an ef-fective internal fixation should be the methodof first choise for management of freshfemoral neck fracture.