小切口人工股骨头置换治疗80岁以上股骨颈骨折

Treatment of femoral neck fracture in aged patients (>80 years) by mini-invasive artificial femoral head replacement

目的探讨前外侧小切口人工股骨头置换治疗高龄股骨颈骨折的治疗效果。方法自2004年8月～2008年12月,对38例80岁以上移位型股骨颈骨折患者施行人工股骨头置换治疗,A组:前外侧小切口入路,18例,B组:后外侧入路,20例。比较两组切口长度、手术时间、术中出血量、输血量、术后12h引流量以及并发症。结果随访6～10周,平均8周。手术持续时间相似,A组切口比B组小,A组术中出血量、术后12h引流量、输血量明显低于B组。结论小切口人工股骨头置换具有出血少、创伤小、少输血、恢复快的优点,尤其适合高龄股骨颈骨折患者。

Objective To study the clinical outcome of mini-invasive artificial femoral head replacement through anterolateral approach for the aged patients （〉80 years） in the treatment of femoral neck fracture. Methods From August 2004 to December 2008,38 cases of displaced femoral neck fracture over 80 years old were randomized into two groups. In group A （18 cases）,mini-invasive artificial femoral head replacement was performed through anterolateral approach,and in group B （20 cases）,through posterolateral approach. The operative time,incision length,intraoperative blood loss,12-h drainage after operation,and transfusion were analyzed and compared. Results Thirty-eight cases were followed up for 6-10 weeks （mean 8 weeks）. The operative time was similar in two groups. The incision length in group A was shorter than that in group B. The intraoperative blood loss,12-h drainage after operation and transfusion in group A were less than those in group B. Conclusion Mini-invasive artificial femoral head replacement through lateral approach has the advantages of reducing blood loss,transfusion,invasion and accelerating rehabilitation,especially for the aged patients.