不同类型假体人工全髋关节置换术治疗交通伤所致老年股骨颈骨折的疗效对比分析

Comparative analysis of efficacy of different types of prosthesis artificial total hip replacement in the treatment of elderly femoral neck fractures caused by traffic injuries

目的对比不同类型假体人工全髋关节置换术治疗交通伤所致高龄股骨颈骨折的疗效差异。方法纳入本院92例交通伤所致老年股骨颈骨折患者,随机分为骨水泥组(46例)与生物组(46例),以人工髋关节置换术治疗时对应选择骨水泥型与生物型假体,对比两组患者围手术期指标、髋关节功能、参与疼痛与并发症情况的差异。结果围手术期,生物组术程短于骨水泥组(P<0.05),术中出血量少于骨水泥组(P<0.05),置换后开始活动时间、住院时间长于骨水泥组(P<0.05);术后,两组Harris评分呈升高趋势,差异具有统计学意义(P<0.05),骨水泥组术后1个月、3个月的Harris评分显著高于生物组(P<0.05),但术后6个月、12个月的评分均显著低于生物组(P<0.05);术后1个月,生物组VAS评分显著高于骨水泥组(P<0.05),术后6个月生物组并发症发生率显著低于骨水泥组(P<0.05)。结论相比于骨水泥假体,以生物型假体行人工全髋关节置换术治疗交通伤所致老年股骨颈骨折患者具有远期髋关节功能恢复更好、术后并发症更少的优势。

Objective To compare and analyze the efficacy of different types of prosthesis artificial total hip replacement in the treatment of elderly femoral neck fractures caused by traffic injuries. Methods 92 cases of elderly patients with femoral neck fractures caused by traffic injuries in the hospital were included and randomly divided into bone cement group (46 cases) and biological group (46 cases). The two groups were given choice of bone cement type prosthesis and biotype prosthesis when treated by artificial hip joint replacement. The perioperative indicators, hip joint function, and participation pain and complications were compared between the two groups. Results In perioperative period, the surgical course in biological group was shorter than that in bone cement group (P<0.05), and the intraoperative blood loss was less than that in bone cement group (P< 0.05), and the activity time and hospital stay after replacement were longer than those in bone cement group (P<0.05). After operation, the Harris scores in the two groups showed an increasing trend, and the differences between the groups were significant (P<0.05), and The Harris scores at 1month and 3 month after operation in bone cement group were significantly higher than those in biological group (P<0.05) while the scores at 6 mon and 12 month after operation were significantly lower than those in biological group (P<0.05). At 1 month after operation, the VAS score in biological group was significantly higher than that in bone cement group (P<0.05), and the incidence rate of complications within half a year in biological group was significantly lower than that in bone cement group (P<0.05). Conclusion Compared with bone cement type prosthesis, biotype prosthesis of artificial total hip replacement has better advantages in long-term hip function recovery and fewer postoperative complications in the treatment of elderly patients with femoral neck fractures caused by traffic injuries.