全髋关节置换术与内固定治疗老年人股骨颈骨折的疗效比较

目的 探讨全髋关节置换术与内固定治疗老年人股骨颈骨折的效果、预后以及并发症.方法 回顾性研究2016年10月至2019年5月79例诊断为Garden I型或Garden II型股骨颈骨折患者的临床资料.将接受全髋关节置换术患者设为第1组,内固定患者为第2组,比较两组的术后活动时间、失血量、住院时间和手术切口长度.此外,检测术后并发症和髋关节功能(Harris评分)以评估两组的最终效果.结果 虽然两组之间的基本特征相似,但第1组的平均手术时间明显多于第2组(P<0.0001).第1组的失血量和手术切口的长度均较大,但与第2组比较,第1组的术后并发症如肺部感染,尿路感染和下肢血栓形成的发生率较低.另外,全髋关节置换术后的功能(Harris评分)也优于内固定术后.结论 全髋关节置换可带来令人满意的临床效果,但与内固定手术比较,手术时间更长,出血量更多.

Objective To evaluate the effects of total hip replacement and internal fixation on the outcome of femoral neck fractures in the Elderly.Methods The clinical data of 79 patients with garden Ⅰ or Garden Ⅱ femoral neck fracture from October 2016 to may 2019 were reviewed.The patients underwent total hip arthroplasty were divided into group 1 and group 2,respectively.In addition,postoperative complications and hip function(Harris score)were measured to evaluate the final effect of the two groups.Results Baseline characteristics were similar between the two groups,but the mean duration of surgery was longer in group 1 than that in group 2(P<0.0001).Blood loss and length of surgical incision were both larger in group 1.However,the incidence of such postoperative complications as lung infection,urinary tract infection and thrombosis of lower limb were lower in group 1 compared with those in group 2.Moreover,the hip Rmction(Harris score)was also better after total hip replacement compared with that after internal fixation.Conclusion Total hip replacement provides satisfactory clinical outcomes,but with longer operation time and increased blood loss compared with internal fixation.