全髋关节置换术治疗股骨颈骨折空心钉内固定失败的疗效分析

Evaluation on clinicla efficacy of t toal hip arthroplasty to treat failure of internal fixation of femoral neck fractures with cannulated scerws

目的：探讨全髋关节置换术对治疗股骨颈骨折空心钉内固定失败后的临床疗效。方法：回顾性分析我科于2009年1月～2013年6月收治的具有完整临床资料的股骨颈骨折空心钉内固定治疗失败后行全髋关节置换23例。其中男9例，女14例；年龄54～72岁，平均63．5岁。所有患者都伴有不同程度的髋部疼痛、跛行等髋部功能障碍，已严重影响生活。使用髋关节Harris评分表评价全髋关节置换术后的临床效果。结果：术后所有患者均获随访，随访时间1～3年，平均2．3年。患者由术前Harris评分43．65±6．16分提升至术后第12个月88．27±5．86分，两者比较差异有统计学意义（p＜0．05），其中优13例，良7例，中3例，优良率87．0％。结论：全髋关节置换可有效治疗股骨颈骨折内固定失效，患者术后功能恢复良好，术后并发症未见明显增加，但术中手术操作难度增加。

Objective：To evaluate the clinical efficacy of total hip arthroplasty to treat the failure of internal fixation of femoral neck fractures with cannulated screws .Methods：Retrospectively analyse 23 cases of apllying total hip arthroplasty to treatwho had complete clinical data after failure of internal fixation of Femoral neck with cannulated screws come from our department since January,2009,to June,2013 .Among them,9 patients were male and 14 patients were female,with an average age of 63.5 years old （ ranged, 54 to 72） . All of the patients with different degree of hip pain ,limp and hip dysfunction,which had severely impacted the quality of life .Evaluation the clinical effect after total hip replacement using Harris hip score.Rseults：All patients received follow-up with an average age of 2.3 years （ranged, 1 to 3） .The Preoperative Harris scores（43.65 ±6.16） increase to （88.27 ±5.86） In the postoperative follow-up of December,The difference was statistically significant （p 〈0.05）.Among them,13 obtained excellent results,7 good and 3 fair.And the excellent and good rate was 87.0%.Conclusion：Total hip replacement should be a satisfactory salvage procedure for failed fracture treat -ment ,Patients＇ functions recover well and the post-operative complications are not found increased obviouslys , But it increases difficulties of operation technique during the operation.