不同手术方法治疗股骨颈骨折的效果对照

Effect Comparison of Different Surgical Methods for Femoral Neck Fracture

目的：探讨全髋关节置换术（THA）、半髋关节置换术（AFHR）、空心钉内固定（CSF）治疗股骨颈骨折的临床疗效.方法：以2008年1月～2017年8月我院129例股骨颈骨折患者为例,依据手术方法分为THA组（60例）、AFHR组（44例）、CSF组（25例）,评估3组疗效,观察3组基本治疗指标,统计并发症及返修率.结果：THA组手术时间114.3±18.5分钟,并发症发生率6.7％,与AFHR组、CSF组比较差异有统计学意义（P〈0.05）,3组治疗优良率分别为83.3％、79.5％和76.0％,差异无统计学意义（P〉0.05）.结论：人工关节置换与复位内固定治疗股骨颈骨折均具有良好疗效.治疗时,临床应综合考虑骨折部位、骨折损伤程度、手术耐受及术后恢复需求等因素择优选择手术方法,以保证治疗效果,提高手术安全.

Objective： To evaluate the clinical effects of total hip replacement （THA）, semi total hip replacement （AFHR） and cannulated screw fixation （CSF） in the treatment of femoral neck fracture. Methods： In January 2008 - 2017 year in August in our hospital 129 cases of femoral neck fracture patients as an example, based on the operation were divided into THA group （60 cases）, AFHR group （44 cases）, CSF group （25 cases）, to evaluate the curative effect of three groups, observation group three basic treatment index, statistical complications and repair rate. Results： The operation time of THA group （ 114.3 ± 18.5 ） min, the complication rate was 6.7%, compared with the AFHR group and CSF group were statistically significant （ P 〈 0. 05 ）, the excellent rate of treatment in the three groups were 83.3%, 79.5% and 76%, the difference was not statistically significant （ P 〉0.05 ）. Conclusion： Both artificial joint replacement and reduction and internal fixation are effective in the treatment of femoral neck fracture. At the time of treatment, the operative method should be selected according to the factors of fracture location, fracture extent, operation tolerance and postoperative recovery demand so as to ensure the effect of treatment and improve the safety of operation.