前外侧入路人工双极股骨头置换治疗高龄患者股骨颈骨折疗效观察

The Effect of Elderly Femoral Neck Fracture with Bipolar Prosthesis through Anterolateral Approach

目的:探讨前外侧入路人工双极股骨头置换治疗高龄患者股骨颈骨折的临床效果。方法:2006年11月-2011年12月笔者所在医院应用前外侧入路骨水泥人工双动股骨头置换术治疗高龄患者股骨颈骨折共30例,男11例,女19例;年龄74～90岁,平均79.6岁。Garden分型:Ⅱ型3例,Ⅲ型11例,Ⅳ型l6例。观察出血量、手术时间及Hanis关节功能评分。结果:本组出血量200～300m1,平均252ml,手术时间45～70min,平均55min;30例患者均获的1～5年随访,平均2年,Harris功能评分68～96分,平均85.7分,优13例,良13例,可3例,差1例。结论:前外侧入路骨水泥人工双动股骨头置换术具有手术出血量少、时间短、术后关节功好等优点,是治疗高龄患者股骨颈骨折的可靠方法。

Objective： To discuss the effect of cemented bipolar prosthesis in aged cases with femoral neck fracture through anterolateral approach. Methods： From November 2007 to December 2012, 30 cases of femoral neck fracture were treated with cemented bipolar prosthesis through anterolateral approach.There were 11 males and 19 females.The age of the group were from 74 to 90 years old, with the average of 79.6 years.There were 3 type I[ , ll type m, 16 type IV, according to Garden＇ criteria.The clinical effect were evaluated with blood loss, operative time, Harris scale and complications.Results： The average blood loss was 252 ml（ranged from 200 to 300 ml）.The average intra-operative time was 55 minutes （ranged from 45 to 70 min）.30 cases were followed up from 1 to 5 years （average 2 years）after surgery, the average score was 85.7 score（ranged from 68 to 96 score）, 13 cases showed excellent results, 13 cases good, 3 cases fair, 1 cases poor according to the evaluate of Harris.Conclusion： Cemented bipolar arthroplasty has good advailtages of less blood loss, shorter operative time, better articular function postoperatively through anterolateral approach.It is a effective method for aged patients with femoral neck fracture.