全髋和半髋置换治疗老年股骨颈骨折的比较研究

Comparison of Safety and Effectiveness of Two Arthroplasty Methods for Displaced Femoral Neck Fractures in the Elderly

目的比较半髋关节置换与全髋关节置换治疗老年移位股骨颈骨折的安全性及有效性差异。方法1999年2月至2007年1月在我院行髋关节置换的老年移位股骨颈骨折(Garden、型)患者共133例,其中全髋关节置换78例,半髋关节置换55例。收集病例资料并进行随访,随访内容包括安全性评估指标及有效性评估指标,具体为术后并发症、术后疼痛率、翻修率及术后髋关节功能评分,统计学分析两种术式的安全性及有效性有无差异。结果8例失访,7例在随访过程中死亡,118例完成随访,随访时间2～10年,平均5.1年。全髋置换组术后并发症发生率高于半髋置换组,翻修率低于半髋置换组,但均无统计学差异;全髋置换组术后疼痛率低于半髋置换组,有统计学差异;术后髋关节功能评分高于半髋置换组,有显著统计学差异。结论全髋关节置换术的安全性和有效性均高于半髋关节置换术,应为首选措施。

Objective To compare the differences of safety and effectiveness between bemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures in the elderlyMethods 133 patients,with displaced femoral neck fractures （GardenⅢ＆Ⅳ）,hospitalized from February 1999 to January 2007,78 patients were treated by total hip arthroplasty, 55 patients were treated by hemiarthroplasty. Collect data as age,gender, fracture types, and main outcome measurements included complication, pain, revision rate, functional outcome （Harris Hip Score）, analyze and compare the safety and the effectiveness between two surgical methodsResults 118 patients were followed up for 2 to 10 （averaged 5.1）years ,8 got lost and 7 died. functional outcome of total hip arthroplasty were better than hemiarthroplasty,and total hip arthroplasty decreased the rates of pain ,there were no statistical difference between hemiarthroplasty and total hip arthroplasty in complication and revision rate. Conclusion Both the safety and the effectiveness of total hip arthroplasty are higher than hemiarthroplasty,thus we recommend total hip arthroplasty as the first choice for displaced femoral neck fractures in the elderly.