全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的对比

Total Hip Arthroplasty and Hemiarthroplasty for the Treatment of Femoral Neck Fracture in the Elderly

目的探讨老年股骨颈骨折中全髋关节置换术与半髋关节置换术治疗的效果及预后情况。方法方便选择该院2014年1月—2016年12月的收治的80例老年股骨颈骨折患者,根据髋关节置换手术方案的不同进行分组,40例半髋关节置换术患者设定为对照组,40例行全髋关节置换术患者为观察组,比较两组患者的手术情况、骨折愈合情况、髋关节功能恢复及术后不良反应情况。结果观察组患者平均手术时间(135.22±19.94)min,术中出血量(626.37±162.37)m L,平均住院时间(22.17±3.26)d,均与对照组患者差异无统计学意义(P>0.05);观察组患者术后疼痛VAS评分(2.10±0.44)分,骨折愈合时间(7.85±0.35)周,术后髋关节功能评分(79.52±7.02)分,治疗效果各项指标均显著优于对照组患者(P<0.05);对照组患者术后并发症发生率为17.50%,观察组为7.50%,观察组并发症发生率显著低于对照组(P<0.05)。结论老年股骨颈骨折患者行全髋关节置换术治疗后可有效修复髋关节损伤,促进骨折端愈合,提高稳定性,手术时间短、术中出血量少,患者术后髋关节功能和生活质量改善显著,并发症少,安全性高和预后好。

Objective This paper tries to explore the effect and prognosis of total hip arthroplasty and hemiarthroplasty with femoral neck fracture in the elderly. Methods 80 patients with femoral neck fracture from January 2014 to December 2016 were convenient selected. According to the procedure of hip replacement surgery, 40 patients with hemiarthroplasty were selected as the control group and 40 patients underwent total hip arthroplasty were selected as the observation group. The operation status, fracture healing, hip function recovery and postoperative adverse reactions were compared between the two groups. Results The average operative time was（135.22 ±19.94）min, the mean blood loss was（626.37±162.37）m L and the average hospitalization time was（22.17±3.26）d in the observation group, without significant difference of the control group（P〈0.05）. The postoperative pain VAS score was（2.10±0.44）points, the time of fracture healing was（7.85±0.35）weeks, the postoperative hip function score was（79.52±7.02）points, the treatment effect were significantly better than the control group（P 0.05）. The incidence of postoperative complications was 17.50% in the control group and 7.50% in the observation group. The incidence of complications in the observation group was significantly lower than that in the control group（P〈0.05）.Conclusion The treatment of total hip arthroplasty in elderly patients with femoral neck fracture can effectively cure the hip joint injury, improve the fracture healing and the stability, whose operation time is short and intraoperative blood loss is small. The patient＇s postoperative hip function and quality of life can be significantly improved, with less complications,high safety and good prognosis.