髋关节置换与骨折内固定术治疗老年股骨颈骨折的效果对比

Comparative analysis on clinical efficacy of hip replacement and fracture fixation for the treatment of elderly patients with femoral neck fracture

目的比较髋关节置换与骨折内固定术治疗老年股骨颈骨折的临床效果。方法选取本院48例老年股骨颈骨折患者,随机均分为髋关节置换组(全髋关节置换术)和骨折内固定组(切开复位内固定术),比较两组患者的手术时间、术中出血量、术后卧床时间、住院时间、临床疗效、并发症发生率和再手术率的差异。结果两组患者手术时间、术中出血量和住院时间比较差异无统计学意义(P>0.05);髋关节置换组患者的术后卧床时间显著短于骨折内固定组(P<0.05)。Harris评分示髋关节置换组优良率为87.5%,显著高于骨折内固定组的62.5%(P<0.05)。髋关节置换组的并发症发生率(12.5%)和再手术率(0)显著低于骨折内固定组(41.9%及37.5%)(P<0.05)。结论髋关节置换术治疗老年股骨颈骨折患者效果确切,能显著缩短术后卧床时间,临床疗效好,并发症发生率低。

Objective To investigate the clinical efficacy of hip replacement and fracture fixation for the treatment of elderly patients with femoral neck fracture.Methods 48 cases of elderly patients with femoral neck fracture in our hospital were randomly divided into hip replacement group （underwent total hip replacement） and fracture fixation group （underwent open reduction and internal fixation）.The operative time,blood loss,postoperative bed rest time,hospital stay time,clinical efficacy,complication rate and reoperation rate was compared between two groups.Results Operative time, blood loss and hospital stay time of two groups had no significant difference （P〉0.05）.Postoperative bed rest time of hip replacement group was significantly lower than that of fracture fixation group （P〈0.05）.Harris scores showed that excel- lent rate of hip replacement group was 87.5%,which was significantly higher than 62.5% of fracture fixation group （P〈0.05）.Complication rate （12.5%） and reoperation rate （0） of hip replacement group was significantly lower than that of fracture fixation group （41.7% and 37.5%） （P〈0.05）.Conclusion Hip replacement for elderly patients with femoral neck fracture has advantages of shorter postoperative bed rest time,better clinical efficacy and less complication rate.