全髋关节置换术与半髋关节置换术治疗股骨颈骨折的近期临床疗效研究

Clinical analysis of the efficacy of total hip arthroplasty and hemiarthroplasty on femoral neck fracture

目的探讨全髋关节置换术与半髋关节置换术治疗股骨颈骨折的近期临床疗效。方法回顾性分析2003年1月至2008年9月本院治疗的72例55岁以上股骨颈骨折患者,根据手术方式分为A组（全髋关节置换术组,32例）和B组（半髋关节置换术组,40例）。术后随访5-6年,平均5.2年。对比两组患者手术时间、术中及术后出血量、并发症发生率及术后功能恢复情况。结果 A组患者手术时间、术中出血量明显高于B组,差异均具有显著性（P〈0.05）,两组患者术后出血量、Harris评分、并发症发生率比较差异均无显著性（P〉0.05）。结论全髋关节置换术与半髋关节置换术是治疗股骨颈骨折的有效方法。半髋关节置换术可优先选择治疗高龄、预期生存期相对较短、活动能力要求不高、术前合并严重内科疾病、手术耐受力差的股骨颈骨折患者。

Objective To investigate the clinical efficacy of total hip arthroplasty and hemiarthroplasty in treatment of hemiarthroplasty femoral neck fracture（FFNF）. Method The clinical materials of 72 FFNF patients with age over 55 years from January 2003 to September 2008 were retrospectively analyzed. The patients were grouped according the operation methods. Group A（n = 32） used hemiarthroplasty method and group B（n = 40） used total hip arthroplasty method. The follow-up was 5 - 6 years, with mean time of 5.2 years. The operation time, intra-operative, post-operative blood loss, complications and function recovery were compared. Result The operation time, intra-operative blood loss in group A were significant higher than group B（P〈 0.05）. The post-operative blood loss, complications and function recovery between two groups had non-significances（P〉 0.05）. Conclusion Both total hip arthroplasty and hemiarthroplasty method are excellent in treatment of FFNF. The hemiarthroplasty method is better in treatment of elder patients with shorter survival time, less activity and with several complications.