骨折内固定术与全髋关节置换术治疗老年股骨颈骨折的临床效果对比

Clinical Effect of Fracture Internal Fixation and Total Hip Arthroplasty for the Treatment of Femoral Neck Fracture in the Elderly

目的对比骨折内固定术与全髋关节置换术治疗老年股骨颈骨折的临床效果。方法选取临沂市人民医院2015年6月—2017年2月收治的108例老年股骨颈骨折患者作为研究对象,按照随机数字表法分为对照组(n=54,实施空心螺钉固定)和实验组(n=54,实施髋关节置换术),比较两组手术指标、治疗效果和术后并发症发生率。结果实验组手术时间(79.4±8.4)min、下地活动时间(6.5±2.4)d短于对照组(86.4±9.5)min、(13.7±3.6)d,术中出血量(221.9±28.3)mL、术后24 h引流量(159.5±20.1)mL少于对照组(265.5±31.6)、(226.8±34.5)mL(P<0.05);对照组治疗优良率77.8%显著低于实验组94.4%,术后并发症发生率18.5%显著高于实验组5.6%,组间差异有统计学意义(P<0.05)。结论全髋关节置换术治疗老年股骨颈骨折的临床效果、安全性优于骨折内固定术,可作为理想治疗方案优先选择和推广使用。

Objective This paper tries to compare clinical effects of fracture internal fixation and total hip arthroplasty in the treatment of femoral neck fractures in the elderly. Methods 108 elderly patients with femoral neck fractures treated in this hospital between June2015 and February 2017 were selected as the study subjects. They were divided into the control group（ n=54, with hollow screw fixation） and the experimental group according to the random number table method（n=54, hip arthroplasty was performed）. The operative indexes, treatment effects, and incidence of postoperative complications were compared between the two groups. Results The operative time（79.4±8.4）min in the experimental group and the activity time（6.5 ±2.4）d in the lower group were shorter than that in the control group（86.4±9.5）min,（13.7±3.6）d, and the intraoperative blood loss was（221.9±28.3）mL. The drainage volume（159.5±20.1） mL in the24 h after treatment was significantly lower than that in the control group（265.5 ±31.6）mL and（226.8±34.5）mL（P〈0.05）. The rate of excellent and good treatment in the control group（77.8%） was significantly lower than that in the experimental group（94.4%）. The prevalence of 18.5% was significantly higher than that of the experimental group（5.6%）, and the difference between the groups was statistically significant（P〈0.05）. Conclusion Total hip arthroplasty is superior to fracture internal fixation in the treatment of femoral neck fractures in the elderly. It can be used as an ideal treatment option and is preferred.