人工关节置换术治疗老年股骨颈骨折疗效观察

Clinical observation of hip replacement for treatment of femoral neck fractures in the elderly

目的探讨单极股骨头置换术(SHA)、双极股骨头置换术(BHA)与全髋关节置换术(THA)治疗老年股骨颈骨折的临床效果。方法 2006年3月至2012年6月共收治老年股骨颈骨折患者95例,其中A组(SHA)24例,B组(BHA)39例,C组(THA)32例。观察三组围术期情况、髋关节功能及并发症。结果 A、B组手术时间、术中出血量及术后引流量均显著少于C组(P<0.05);A组髋关节疼痛等并发症发生率高于B组及C组(P<0.05),B、C组间差异无统计学意义(P>0.05);三组患者术后一年髋关节Harris评分差异无统计学意义(P>0.05)。结论三组患者均能获得良好的髋关节功能,A、B组手术时间短、术中、术后出血量少,B、C组并发症较少。双极人工股骨头是治疗老年股骨颈骨折患者的理想选择之一。

Objective To observe the clinical effect of the single femoral head replacement （SHA）, bipolar femoral head replacement （BHA） and total hip arthroplasty （THA） for the treatment of femoral neck fracture in the elderly. Methods From 2006 to 2012, ninety-five elderly patients with femoral neck fracture were included in the study. 24 cases in group A treated by SHA, 39 cases in group B treated by BHA, 32cases in group C treated by THA. The intraoperative conditions, hip joint function and complications of three groups were observed. Results The mean operation time and the intraoperative and postoperative blood loss in group C were significantly more than the other two groups. The pain and other complications in group A were higher than the others. According to Harris scoring system, The excellent and good rates had no significant differences in every group. Conclusions All groups can obtain good hip function, there are less invasive in group A and B, fewer complications in group B and C. BHA is a better choice for the treatment of femoral neck fracture in the elderly.