前外侧入路半髋置换治疗股骨颈骨折伴脑梗死后遗症患者术后临床效果观察

Clinical effect of anterolateral approach hemi hip arthroplasty in old patients with femoral neck fracture and cerebral infarction sequela

目的评价前外侧入路对于股骨颈骨折伴随脑梗死后遗症的患者的临床疗效。方法回顾性的分析2009年3月至2014年3月来首都医科大学附属北京朝阳医院就诊的伴有脑梗死后遗症的股骨颈骨折患者共26例,平均年龄76.4（69～89）岁。所有患者均采用前外侧入路半髋置换的方法,观察最后一次随访时的影像学表现、术后Harris髋关节评分以及出现不良事件情况。结果 26例患者平均随访时间44.8（15～72）个月。X线片均显示假体位置良好,Harris评分评价,术后2例优（90～100分）,14例良（80～90分）,6例可（70～79分）,4例差（〈70分）,优良率61.5%。5例出现术后合并症,1例患者脑梗死复发。所有患者未出现髋关节脱位。结论前外侧手术入路的半髋置换具有创伤小、暴露清楚、操作便利等优点,同时可以大大降低股骨颈骨折伴随脑梗死后遗症的患者发生脱位的概率,临床效果满意。

Objective To evaluate clinical effect of anterolateral approach hemi hip arthroplasty in old patients with femoral neck fracture and cerebral infarction sequela. Methods From March 2009 to March 2014,26 patients with femoral neck fracture and cerebral infarction sequela with an average age of 76. 4 years（ 69-89） were retrospectively analyzed in our hospital. All of the patients received the hemi hip arthroplasty through anterolateral approach,and imaging findings,Harris hip score as well as the occurrence of adverse events were recorded at the last follow-up. Results Eventually 26 patients were included with an average follow-up of 44. 8 months（ 15-72months）. All of the X-rays have shown good prosthesis position,according to Harris score evaluation,2 cases were excellent（ 90-100）,14 cases were good（ 80-90）,and 6 cases were medium（ 70-79）,4 cases Corresponding author,Email： Linyuan@ medmail. com. cnwere poor（ 70）,the fineness rate was 61. 5%. Five cases suffered from postoperative complications and in 1 of cerebral infarction patients the disease recurred. None of them developed dislocation. conclusion Anterolateral approach hemi hip arthroplasty is less traumatic,clear and convenient to operate,and has other advantages,at the same time it can greatly reduce the incidence rates of dislocation,and clinical effect is satisfactory.