中老年股骨颈骨折全髋关节置换术和骨折内固定术临床比较

Clinical comparison of total hip arthroplasty and fracture internal fixation for femoral neck fractures in middle-aged and elderly patients

目的比较分析中老年股骨颈骨折患者采用全髋关节置换术治疗和骨折内固定术治疗的临床效果。方法 78例中老年股骨颈骨折患者,随机分为观察组与对照组,每组39例。对照组患者采用骨折内固定术进行治疗,观察组患者采用全髋关节置换术进行治疗。比较两组患者手术情况、术后关节状况、术后并发症发生情况。结果观察组患者手术时间(68.21±12.01)min短于对照组的(92.63±23.51)min,术中出血量(265.41±23.01)ml、术后引流量(68.08±10.62)ml均少于对照组的(418.62±41.62)、(89.14±15.24)ml,术后Harris评分(92.05±4.02)分高于对照组的(72.63±5.35)分,差异具有统计学意义(P<0.05)。观察组患者术后并发症发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论临床中,中老年股骨颈骨折患者采用全髋关节置换术进行治疗,治疗效果比骨折内固定术更好,且具有一定的安全性,值得推广使用。

Objective To compare and analyze the clinical effect of total hip arthroplasty and fracture internal fixation for femoral neck fractures in middle-aged and elderly patients. Methods A total of 78 middle- aged and elderly patients with femoral neck fractures were randomly divided into observation group and control group, 39 cases in each group. Patients in the control group were treated with fracture internal fixation, patients in the observation group were treated with total hip arthroplasty. The operative condition, postoperative joint condition and postoperative complications between the two groups were compared. Results The operative time of the observation group was （68.21 ±12.01） min, which was significantly shorter than （92.63 ± 23.51） min, the intraoperative blood loss and postoperative drainage volume of the observation group were （265.41 ±23.01） ml and （68.08 ± 10.62） ml respectively, which were significantly less than （418.62 ＋ 41.62） ml and （89.14 ＋ 15.24） ml of the control group, the postoperative Harris score of the observation group was （92.05 ±4.02） scores, which was significantly higher than （72.63 ± 5.35） scores of the control group, the differences were statistically significant （P〈0.05）. The incidence of postoperative complications in the observation group was significantly lower than that in the control group, the difference was statistically significant （P〈0.05）. Conclusion In clinical practice, the treatment effect of total hip arthroplasty for femoral neck fractures in middle-aged and elderly patients is better than that of fracture internal fixation, and has certain safety, it is worthy of promotion and use.