人工髋关节置换术治疗老年股骨颈囊内骨折疗效分析

Clinical Efficacy of Hip Arthroplasty in the Treatment of Intracapsular Femoral Neck Fracture in Elderly Patients

目的观察人工髋关节置换术治疗老年股骨颈囊内骨折的临床疗效及对术后日常生活能力的影响。方法选取2010年1月-2012年12月符合股骨颈囊内骨折（GardenⅢ、Ⅳ型）,年龄65～85岁的患者198例,采取人工髋关节置换手术治疗。随诊观察患髋术后髋关节Harris评分、Barthel指数评分、术后并发症以及日常生活能力。结果 198例患者获1年以上（12～30个月,平均15.6个月）的随访。术后12个月Harris评分85～98分,平均94.5分。Barthel指数评分86～97分,平均94.0分。术后主要并发症包括切口皮下脂肪液化3例,下肢深静脉血栓形成2例,褥疮2例,肺部感染4例,脱位2例,疼痛4例,并且95%以上的患者恢复了术前的生活,治疗效果满意。结论人工髋关节置换术治疗老年股骨颈囊内骨折疗效显著,可避免长期卧床引起的并发症,早期恢复日常生活能力,适合临床上广泛应用。

Objective To investigate the clinical efficacy of hip arthroplasty in treating intracapsular femoral neck fracture in elderly patients. Methods From January 2010 to December 2012, 198 patients with intracapsular femoral neck fractures（Garden Ⅲ and Ⅳ）, aged between 65 and 85 years old were selected to be treated with hip arthroplasty. Clinical evaluation including Harris hip score, Barthel index, postoperative complications and activities of daily living were performed. Results The patients were followed up for an average time of 15.6 months. At the follow-up time of 12 months, the Harris scores were 85-98, averaging 94.5; the Barthel indexes were 86-97, averaging 94.0. The main postoperative complications were subcutaneous fat necrosis（3 cases）, deep venous thrombosis of lower limbs（2 cases）, bedsores（2 cases）, pulmonary infection（4 cases）, dislocation（2 cases） and pain（4 cases）. More than 95% of the patients had a satisfactory treatment and recovered activities of daily living. Conclusion Hip arthroplasty reduces postoperative complications caused by prolonged bed rest and helps the patients get back to normal activities of daily living early, so it is an effective method to treat intracapsular femoral neck fractures and is suitable for widespread clinical application.