全髋关节置换术与双极人工股骨头置换术治疗老年股骨颈骨折的疗效比较

Efficacy Comparison of Total Hip Arthroplasty and Bipolar Prosthesis in Treatment of Femoral Neck Fracture in Elderly Patients

目的比较全髋关节置换术与双极人工股骨头置换术治疗老年股骨颈骨折的疗效。方法共70例老年股骨颈骨折患者纳入研究,40例行全髋关节置换术,30例行双极人工股骨头置换术。比较两组手术时长、术中出血量、术后总引流量,以及术后1个月、3个月时的视觉模拟评分和术后3个月时的髋关节Harris评分,并比较两组术后并发症发生情况。结果所有患者均随访3个月。与全髋关节置换组相比,双极人工股骨头置换组手术时间短、术中出血量较少、术后总引流量较少(P<0.05)。两组患者术后1个月、3个月时的VAS评分,以及术后3个月时的髋关节Harris评分均无统计学差异(P>0.05)。除全髋关节置换术组有1例出现关节脱位,两组患者未出现伤口感染、假体周围骨折等并发症。结论对于老年股骨颈骨折,全髋关节置换术与双极股骨头置换术均可获得满意疗效,但对于创伤严重、手术耐受能力较差的患者,推荐采用双极股骨头置换手术。

Objective To compare the effect of total hip replacement and bipolar artificial femoral head replacement in treatment of femoral neck fracture in elderly patients.Methods Seventy elderly patients with femoral neck fracture were enrolled,40 patients were treated with total hip replacement,30 patients were treated with bipolar artificial femoral head replacement.The operation time,intraoperative blood loss,postoperative total drainage volume,VAS score 1 month and 3 months after operation,Harris score 3 months after operation and postoperative complications were compared between the two groups.Results All patients were followed up for 3 months.Compared with total hip replacement group,the operation time of bipolar artificial femoral head replacement group was shorter,the amount of intraoperative bleeding was less,and the total amount of postoperative drainage was less,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in VAS score 1 month and 3 months after surgery and Harris score 3 months after surgery(P>0.05).Except for 1 case of dislocation in the total hip replacement group,no complications such as wound infection and periprosthetic fracture occurred in the two groups.Conclusion In the elderly patients with femoral neck fractures,both total hip replacement and bipolar femoral head replacement can achieve satisfactory result.Bipolar femoral head replacement is recommended for patients with severe trauma and poor tolerance.