快捷小切口与常规切口人工髋关节置换术治疗老年股骨颈骨折的疗效对比

Comparison the efficacy of minimally invasive and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly

目的对比快捷小切口与常规切口行人工髋关节置换治疗老年股骨颈骨折的临床疗效。方法将240例老年移位股骨颈骨折随机分为全髋置换小切口组、全髋置换常规切口组、半髋置换小切口组、半髋置换常规切口组(各60例)。对每组切口长度、手术时间、出血量、术后引流量、下地活动时间、术后Harris评分方面进行统计学分析。结果全髋置换、半髋置换组中小切口与常规切口组在切口长度、手术时间、出血量、术后引流量、下地活动时间方面差异有统计学意义(P<0.05);术后6周Harris评分差异无统计学意义(P>0.05)。小切口组术后疗效优于常规切口组。结论快捷小切口人工髋关节置换术具有切口小、手术时间短、创伤小、出血少、瘢痕小、术后功能恢复快等优点,是治疗老年移位股骨颈骨折的理想方法。

Objective To compare the efficacy of the minimally invasive incision and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly. Methods All of 240 old patients with displaced femoral neck fracture were randomly divided into four groups, the minimally invasive incision total hip replacement group, the conventional incision total hip replacement group, the minimally invasive incision femoral head arthroplasty group, and the conventional incision femoral head arthroplasty group, 60 cases each. Then each group underwent statistical analysis, for incision length, operation time, the amount of blooding, postoperative drainage volume,activity time and Harris score after operation. Results There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimaLly invasive incision total hip replacement group and conventional incision group （P 〈0.05）. There was no significant difference in Harris score for 6 weeks after operation （P 〉0.05）. There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision femoral head arthroplasty group and conventional incision group （P 〈0.05）. There was no significant difference in Harris score for 6 weeks after operation （P 〉0.05）. The efficacy of minimally invasive incision group was better than conventional incision group. Conclusion The minimally invasive incision hip arthroplasty has the advantages of minimal incision, short operation time, less trauma, little scar, quicker recovery. It is an ideal method for treatment of displaced femoral neck fracture in elderly.