小切口人工股骨头置换治疗高龄股骨颈骨折

Mini-incision Artificial Femoral Head Replacement for Femoral Neck Fracture in Senile Patients

目的 探讨小切口人工股骨头置换治疗高龄股骨颈骨折的临床疗效.方法 对82例股骨颈骨折患者均采用小切口人工股骨头置换治疗.术后随访时间6个月～4年6个月,观察临床疗效及假体的形态、位置和有无松动及下沉的情况.结果 82例患者中,17例失访,65例获得随访.Harris评分由术前的平均41.4分（32～58分）,提高到末次随访的平均89分（78～95分）.按Harris评分标准：优27例,良31例,一般5例,差2例,优良率为89.2％.下肢深静脉血栓、假体周围骨折、髋关节前脱位及髋关节后脱位各1例.无关节感染及假体松动、下沉的发生.结论 小切口人工股骨头置换治疗高龄股骨颈骨折安全、有效,并可促使老年人早期活动,恢复关节功能,提高生活质量.

Objective To investigate the curative effect of miniincision artificial femoral head replacement on femoral neck fracture in senile patients. Methods A total of 82 senile patients with femoral neck fracture were treated with miniincision artificial femoral head replacement. Patients were followed up for 654 months to observe the clinical efficacy and the shape,position,loosening and ubsidence of prosthesis. Results Among the 82 patients, 17 were lost to followup.Harris score increased from preoperative 41.4 points （range, 3258 points） to 89 points （range ,7895 points） at the last followup. The clinical outcome was excellent in 27 patients, good in 31 ,fair in 5,and poor in 2. The excellent and good rate was 89.2%.In addition,deep venous thrombosis of the lower limbs, peripr osthetic fracture, anterior dislocation of hip joint and posterior dislocation of hip joint occurred in 1 patient ,respectively.No patients had joint infection and prosthetic loosening or subsidence. Conclusion Miniincision artificial femoral head replacement is a safe and effective treatment, which can promote early activity and joint function recovery and improve the quality of life in senile patient with femoral neck fracture.