大头金对金全髋关节置换治疗老年人股骨颈骨折近期疗效

Short-term clinical effect of large diameter metal-on-metal total hip arthroplasty for the elderly patients with femoral neck fractures

目的探讨大头金对金全髋关节置换术治疗老年人股骨颈骨折的近期疗效。方法 55例老年股骨颈骨折患者(55髋)中,26髋采用大头金对金全髋关节置换(观察组),29髋采用常规小头金属对聚乙烯全髋关节置换(对照组),比较两组的临床疗效,对并发症进行分析。结果 55例门诊随访12～23(18.3±5.4)个月。术后对照组发生脱位1例2次;观察组无脱位发生。观察组术后6、12周的髋关节活动范围和术后12个月的Harris评分优秀率均优于对照组,差异有统计学意义(P<0.05)。结论大头金对金全髋关节置换术治疗老年股骨颈骨折,具有术后脱位率低、关节活动范围大等优点,近期临床疗效满意。

Objective To discuss the short-term clinical effect of large diameter metal-on-metal total hip arthroplasty （THA） in elderly patients with femoral neck fractures. Methods 55 elderly femoral neck fractures patients with 55 hips underwent the operation of THA, 26 hips were performed with large diameter metal-on-metal hip prosthesis （ experimental group ）, other 29 hips were performed with conventional diameter metal-on-polyethylene hip prosthesis （ control group） , the clinical effect were compared between the two groups and the complications were analyzed. Resuits All of the 55 patients were followed up in outpatient for 12 - 23 （ 18.3 ± 5.4） months. In control group, dislocation occurred in 1 ease for 2 times while no dislocation happened in experimental group. Compared with control group, the experimental group had better range of motion in 6 and 12 weeks postoperative and higher excellent rate of Harris score 12 months postoperative, there was statistical difference between the two groups （P 〈 0. 05 ）. Conclusions Large diameter metal-on-metal THA in treating elderly patients with femoral neck fractures had satisfactory short-term clinical outcome with low rate of postoperative dislocation and good range of motion.