髋关节置换术与骨折内固定术治疗老年股骨颈骨折的临床效果对比研究

Comparative study on the clinical effect between hip replacement and internal fracture fixation in the treatment of elderly femoral neck fractures

目的对比分析髋关节置换术与骨折内固定术治疗老年股骨颈骨折的临床效果。方法回顾性分析2019年3月至2020年3月期间我院收治的老年股骨颈骨折患者共105例,按照治疗方法分为两组,对照组52例用骨折内固定术治疗,研究组53例用髋关节置换术治疗,对比分析两组治疗效果、Harris评分、关节功能恢复情况。结果与对照组比较,研究组骨折愈合时间、下床时间、住院时间[(12.9±2.2)周vs.(17.1±3.6)周、(14.3±1.8)d vs.(28.8±5.7)d、(12.0±2.1)d vs.(17.4±4.0)d]均更短,两组差异有统计学意义(P<0.05)。治疗后两组Harris评分均高于治疗前,差异有统计学意义(P<0.05);治疗后研究组Harris评分高于对照组[(80.2±13.6)分vs.(71.9±10.3)分],差异有统计学意义(P<0.05)。与对照组比较,研究组关节功能优良率(92.4%vs.71.1%)更高,两组差异有统计学意义(P<0.05)。结论髋关节置换术与骨折内固定术治疗老年股骨颈骨折患者均能收到良好的治疗效果,但髋关节置换术治疗能够更好地缩短患者骨折愈合时间、下地时间及住院时间,能够促进患者更好地恢复功能状态。

Objective To compare and analyze the clinical effect between hip replacement and internal fracture fixation in the treatment of elderly femoral neck fractures.Methods A total of 105 elderly patients with femoral neck fractures admitted to our hospital from March 2019 to March 2020 were retrospectively analyzed.They were divided into two groups according to treatment methods.The control group(n=52)was treated with internal fracture fixation,and the study group(n=53)was treated with hip replacement.The treatment effect,Harris score and joint function recovery of the two groups were compared and analyzed.Results Compared with those of the control group,the fracture healing time,the time of going to the ground,and the hospitalization time in the study group were shorter([12.9±2.2]weeks vs.[17.1±3.6]weeks,[14.3±1.8]d vs.[28.8±5.7]d,[12.0±2.1]d vs.[17.4±4.0]d),and the difference between the two groups was statistically significant(P<0.05).After treatment,the Harris scores of the two groups were higher than those before treatment,and the difference was statistically significant(P<0.05).The Harris score of the study group was higher than that of the control group([80.2±13.6]points vs.[71.9±10.3]points),and the difference was statistically significant(P<0.05).Compared with that of the control group,the excellent and good rate of joint function in the study group was higher(92.4%vs.71.1%),and the difference between the two groups was statistically significant(P<0.05).Conclusion Both hip replacement and internal fracture fixation can achieve good results in the treatment of elderly patients with femoral neck fractures,but hip replacement can better shorten the fracture healing time,the time of going to the ground and the length of stay,which can promote patients to better recover their functional status.