经后路小切口行全髋关节置换术治疗老年人股骨颈骨折的临床研究

Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fracture in the senile

目的 探讨采用后路小切口行全髋关节置换术（MIS-THA）治疗老年股骨颈骨折的的临床效果.方法 本组42例60岁以上股骨颈骨折患者,男20例,女22例;年龄60～78岁,平均74.2岁,均为外伤后股骨颈囊内移位骨折.全部患者行后路MIS-THA.结果 平均随访12～24个月,平均13个月.平均切口长度8.4 cm,术中出血和术后引流量（308.0±169.1）ml,平均手术时间 70 min.术后X线检查示假体位置良好,出现1例术后脱位,2例下肢不等长,2例下肢深静脉血栓形成.结论 MIS-THA具有出血少,创伤小,输血少,恢复快等优点,尤其适合老年股骨颈骨折的患者.

Objective To study the therapeutic results of total hip arthroplasty （THA） with minimal incision for the treatment of femoral neck fractures in the senile. Methods 42 cases with displaced intra capsule femoral neck fractures were treated with posterior minimal incision THA. The ages of all cases were over 60 years, among that 20 cases were male and 22 cases were female. The average age was 74. 2 years, ranging from 60 to 78 years. 42 cases were followed up for 12 to 24 months, 13 months in average. Results In average, the incision length was 8.4 cm, and blood loss was （ 308.0 ±169.1 ） ml. The average duration of the operation was 70 minutes, X-ray examination of prosthesis position was good. One case had dislocation of THA; two cases had leg length discrepancy; another two cases had deep vein thrombosis after operation. Conclusions THA with posterior minimal incision has the advantages of less blood loss, less soft tissue damage, less blood transfusion as well as accelerating rehabilitation. Especially good for the elderly patient with femoral neck fractures.