双极人工股骨头置换术与全髋关节置换术治疗老年股骨颈骨折效果分析

Comparison of efficacy of bipolar artificial femoral head replacement and total hip arthroplasty in treatment of femoral neck fracture of elderly patients

目的比较双极人工股骨头置换术(BFHR)与全髋关节置换术(THA)治疗老年股骨颈骨折的效果。方法选取2013-05—2017-02间巩义市中医院收治的74例老年股骨颈骨折患者。将42例采用BFHR治疗的患者作为BFHR组,将32例行THA治疗的患者作为THA组。比较2组手术时间、术中失血量、术后引流量。依据Harris髋关节功能评分标准比较2组患者术后6、12个月时的关节功能及术后并发症。结果 BFHR组的手术时间、术中出血量、术后引流量均优于THA组,差异有统计学意义(P<0.05)。术后6、12个月时随访结果显示,THA组的患髋关节Harris评分均优于BFHR组,差异有统计学意义(P<0.05)。BFHR组2例发生髋臼磨损,但2组术后并发症发生率差异无统计学意义(P>0.05)。结论 BFHR治疗老年股骨颈骨折创伤小,手术时间短;而THA的远期疗效满意,无髋臼磨损等并发症。应根据患者的年龄、全身情况及骨折类型等进行综合分析,个体化选择术式。

Objective To compare the efficacy of bipolar artificial femoral head replacement(BFHR)and total hip arthroplasty(THA)in the treatment of femoral neck fractures of elderly patients.Methods From May 2013 to February 2017,74 cases of femoral neck fractures in the elderly patients were treated in our hospital.Among them,42 patients were treated with BFHR and 32 patients were treated with THA.The operation time,intraoperative blood loss,and postoperative drainage were compared between the two groups.Harris joint hip function scores were used to evaluate and compare joint function at 6,12 months after surgery.The postoperative complications of the two groups were compared.Results All 74 patients were followed up for 11 to 23 months.The operation time,intraoperative blood loss,and postoperative drainage volume in the BFHR group were better than those in the THA group(P<0.05).Follow-up results at 6 and 12 months postoperatively showed that Harris hip scores in the THA group were better than those in the BFHR group,and the difference was statistically significant(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05),but there were 2 cases of acetabular wear in the BFHR group.Conclusion The treatment of senile femoral neck fracture by BFHR had little trauma and short operation time,while the long term effect of THA was satisfactory,and no acetabular wear and other complications.According to the patient's age,whole body condition and fracture type,the operative method should be individualized.