全髋关节置换对股骨颈骨折及股骨头坏死术后股骨近端形态改变的影响

Effect of Total Hip Arthroplasty on Morphological Changes of Proximal Femur in Patients with Femoral Neck Fracture and Necrosis of Femoral Head

目的分析并观察全髋关节置换治疗股骨颈骨折及股骨头坏死术后股骨近端形态改变是否存在差异性及表现形式。方法选取2015年10月-2017年10月期间我院收治的34例股骨颈骨折患者和58例股骨头坏死患者,所有患者均行全髋关节置换治疗,分析并比较所有患者术后股骨高度、调整方式、Offest以及截骨位置。结果股骨颈骨折患者治疗后股骨高度、截骨位置均低于股骨头坏死患者,股骨颈骨折患者治疗后Offest小于股骨头坏死患者,并发现三种低位截骨后的调整方式。结论全髋关节置换手术对股骨颈骨折会产生较小Offest及低截骨的可能,因为低位截骨而进行调整对患者近期、远期治疗效果可能均会产生不利影响。

Objective To analyze and observe the differences and manifestations of the proximal femoral changes after total hip arthroplasty in the treatment of femoral neck fracture and femoral head necrosis.Methods Totally 34 patients with femoral neck fracture and 58 patients with femoral head necrosis admitted to our hospital from October 2015 to October 2017 were enrolled in this study.All patients underwent total hip arthroplasty.All postoperative femur Height,adjustment,Offest and osteotomy position.Results After femoral neck fracture,the femoral height and osteotomy position were lower than those in patients with femoral head necrosis.Offest was lower in patients with femoral neck fracture than those in femoral head necrosis after the treatment,and three kinds of postosteotomy adjustment were found.Conclusion Total hip arthroplasty has the potential of producing smaller Offest and lower osteotomy for femoral neck fractures.Adjusting the lower osteotomy may have adverse effects on the short-term and long-term outcomes of patients.