全髋关节置换术与复位内固定术治疗老年患者股骨颈骨折的临床疗效分析

Clinical Analysis of Total Hip Replacement and Reduction and Internal Fixation in the Treatment of Femoral Neck Fracture in Elderly Patients

目的比较全髋关节置换术和复位内固定术两种不同的手术方法治疗老年患者股骨颈骨折的临床疗效。方法选择我科2013年1月至2017年1月收治的83例老年股骨颈骨折患者为研究对象,根据手术方法的不同分为全髋关节置换组和复位内固定组。比较两组患者手术时间、术中出血量、术后下床时间、术后并发症发生率及髋关节功能恢复情况。结果髋关节置换组患者手术时间和术中出血量大于复位内固定组(P<0.05),但术后下床时间及并发症发生率低于复位内固定组(P<0.05)。术后1年随访,全髋关节置换组患者髋关节功能恢复情况优于复位内固定组(P<0.05)。结论基础疾病严重、手术耐受差且骨折没有明显移位的老年患者,复位内固定术仍是首选方式,而身体素质好、骨折移位明显的患者,全髋关节置换术能够起到更好的治疗效果。

Objective To compare the clinical effects of total hip replacement and reduction and internal fi xation in the treatment of femoral neck fracture in elderly patients.Methods 83 elderly patients with femoral neck fracture admitted to our department from January 2013 to January 2017 were selected as the research objects.According to the different surgical methods,they were divided into total hip replacement group and reduction and internal fi xation group.The operation time,intraoperative bleeding volume,time to get out of bed after operation,incidence of complications and recovery of hip function were compared between the two groups.Results The operation time and intraoperative bleeding volume of hip replacement group were larger than those of reduction and internal fi xation group(P<0.05),but the time of getting out of bed and the incidence of complications were lower than those of reduction and internal fi xation group(P<0.05).After 1 year follow-up,the recovery of hip function in total hip replacement group was better than that in reduction and internal fi xation group(P<0.05).Conclusion Reduction and internal fi xation is still the preferred method for elderly patients with serious underlying diseases,poor surgical tolerance and no obvious displacement of fracture.Total hip arthroplasty can play a better therapeutic effect for patients with good physical fi tness and obvious displacement of fracture.