全髋关节置换与内固定治疗股骨颈骨折疗效比较

COMPARISON BETWEEN TOTAL HIP REPLACEMENT AND INTERNAL FIXATION FOR FEMORAL NECK FRACTURES

目的比较全髋关节置换术与内固定术治疗股骨颈骨折的疗效。方法回顾性总结35例行内固定术、31例行全髋关节置换术治疗股骨颈骨折病人的临床随访资料,术后平均随访时间3.8年。结果全髋关节置换术后优良率71.0%,27例无病废病人平均Harris评分90.4;内固定治疗术后优良率48.6%,20例无病废病人平均Harris评分91.6,15例严重病废病例中股骨头坏死与骨折不愈合各6例,其他原因3例,股骨头坏死病人年龄均小于65岁。结论全髋关节置换是股骨颈骨折有效的治疗方法。65岁以上股骨颈骨折病人,有时也可行内固定治疗。

Objective To compare the results of internal fixation （IF） and total hip replacement （THR） in the treatment of femoral neck fracture. Methods The clinical data of 35 cases of femoral neck fracture treated with TF and 31 with THR from 1990 to 2002 were studied retrospectively. The average follow-up was 3.8 years. Results The excellent rate in THR group was 71.0%, and the average Harris score was 90. 4; while in the IF group, it was 48.6% and 91.6, respectively. All the six patients with femoral head necrosis were younger than 65 years old. Conclusion Total hip replacement is suitable for elder patients with femoral neck fracture. For those more than 65 IF can be done as well.