SuperPATH入路双极股骨头置换治疗老年股骨颈骨折

Bipolar femoral head replacement via SuperPATH approach for treament of femoral neck fracture in the elderly

目的探讨SuperPATH入路双极股骨头置换治疗老年股骨颈骨折的临床疗效。方法采用SuperPATH入路双极股骨头置换治疗37例老年股骨颈骨折患者,其中水泥型16例,生物型21例。记录切口长度、手术时间、术中出血量,采用疼痛VAS评分、髋关节Harris评分评价手术效果。结果切口长度7.0~8.5(7.77±0.44)cm,手术时间50~130(96.41±23.74)min,术中出血量50~300(112.70±64.41)ml。37例患者均获得随访,时间6~29(16.62±1.17)个月。VAS评分术后6个月与术后3个月比较差异有统计学意义(P<0.05)。术后6个月与术后3个月、末次随访与术后6个月髋关节Harris评分比较差异均有统计学意义(P<0.05)。末次随访时无假体松动、失败、翻修病例。结论SuperPATH入路双极股骨头置换治疗老年股骨颈骨折创伤小,学习曲线不长,疗效满意。

Objective To investigate the clinical effect of bipolar femoral head replacement via SuperPATH approach in the treatment of femoral neck fracture in the elderly.Methods Thirty-seven elderly patients with femoral neck fracture were treated with bipolar femoral head replacement via SuperPATH approach,including 16 cases of cement type and 21 cases of biological type.The length of incision,operation time,intraoperative bleeding volume were recorded,pain VAS and Harris score of hip joint were observed to evaluate the effect of operation.Results The incision length was 7.0~8.5(7.77±0.44)cm,the operation time was 50~130(96.41±23.74)min,and the intraoperative bleeding volume was 50~300(112.70±64.41)ml.Thirty-seven patients were followed up for 6~29(16.62±1.17)months.The VAS of 3,6 months after operation had statistical difference(P<0.05).There were significant differences in Harris score of hip joint between 3 months and 6 months,as well as 6 months and the last follow-up(P<0.05).No cases of prosthesis loosening,failure or revision were found at the last follow-up.Conclusions The SuperPATH approach is feasible for the treatment of femoral neck fracture in the elderly,with short learning curve and satisfactory effect.