全髋及半髋置换术对老龄股骨颈骨折的疗效

Curative Efficacy of Total Hip Replacement or Hemiarthroplasty in Elderly Patients with Femoral Neck Fractures

目的探讨全髋及半髋置换术对老龄股骨颈骨折的疗效。方法回顾性分析65例确诊为股骨颈骨折并行人工髋关节置换术的高龄患者的临床资料,其中33例采用全髋置换术(全髋组),32例采用半髋置换术(半髋组)。比较2组患者的手术时间、术中出血量及住院时间等指标,观察1年随访后的远期疗效并评分。结果全髋组手术时间及术中出血量高于半髋组(P<0.05);住院时间2组差异无统计学意义(P>0.05);2组的远期疗效不同,且全髋组(平均秩和=38.24)好于半髋组(平均秩和=27.59)。结论全髋及半髋置换术治疗老龄股骨颈骨折均有肯定的疗效,远期疗效前者优于后者。需根据患者具体情况选择合理、个体性的治疗方案。

Objective To investigate the curative efficacy of total hip replacement or hemiarthr- oplasty in elderly patients with femoral neck fractures. Methods Clinical data of 65 elderly patients who underwent artificial hip replacement for femoral neck fractures were analyzed retrospectively. These patients were treated with total hip replacement（total hip replacement group, n=33） or hemiarthroplasty （hemiarthroplasty group, n=32）. The operation time, intraoperative blood loss and hospital stay were observed and the tong-term efficacy was evaluated after 1 year of follow-up. Results Compared with hemiarthroplasty group, the operation time and intraoperative blood loss significantly increased in total groups （P〉0.05）. In addition, the long-term efficacy in total hip replacement group （average rank= 38.24）was significantly better than that in hemiarthroplasty group （average rank=27.59）（P〈0.05）. Conclusion Total hip replacement is superior to hemiarthroplasty for treating femoral neck fractures in elderly patients. Reasonable and personalized treatment approach should be selected according to patients, condition.