高龄老年人股骨颈骨折人工全髋与半髋关节置换术的选择

Total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fracture

目的探讨全髋关节置换术与半髋关节置换术在高龄老年人(≥85岁)股骨颈骨折中的疗效比较。方法本组在2004年至2007年共收治67例股骨颈骨折的高龄患者,其中17例采用全髋关节置换术治疗;其余50例采用半髋关节置换术治疗。随访3个月～4年,平均3.1年。对两组患者的手术时间、手术出血量、住院时间、住院费用、并发症、关节功能等进行比较。结果全髋关节置换组的平均手术时间、术中出血量、住院费用等明显要多于半髋关节置换组,差异有统计学意义(P<0.05)。住院时间、并发症、关节功能等比较,差异无统计学意义(P>0.05)。结论对高龄老年人(≥85岁)股骨颈骨折的治疗尽可能采用简单有效的手术方法,半髋关节置换术完全可以满足该类患者的需求。

Objective To compare the effects of total hip arthroplasty and hemiarthroplasty in treatment of femoral neck fracture in elderly patients （ more than 85 years old）. Methods Sixty-seven elderly patients with femoral neck fractures treated by total hip arthroplasty （17 cases） or hemiarthroplasty （50 cases） between 2004 and 2007 were reviewed. The follow-up period ranged from 3 months to 4 years （mean, 3.1 years）. Operation time, intraoperative blood loss, hospitalization period, cost of hospitalization, complications, joint function and mortality rate were all compared. Results There was significant difference between two groups in the comparison of operation time, blood lost during operation and cost of hospitalization （P 〈 0. 05）. Conclusions with hospitalized period, complications, joint function and mortality rate, there were no significant difference in two groups （P 〉0. 05）. Conclusions Hemiarthroplasty is a reasonable choice for the treatment of the femoral neck fracture in elderly patients （more than 85 years old）.