髋部骨折内固定失败后全髋关节置换术的疗效及相关因素分析

Analysis of the curative effect and related factors of total hip arthroplasty after failure of internal fixation of hip fracture

目的探究髋部骨折内固定失败后全髋关节置换术的疗效及相关影响因素。方法随机抽取2015年1月至2018年6月本院48例髋部骨折内固定失败患者为观察对象,对其实施全髋关节置换术治疗,均随访半年,对比治疗前后髋关节功能评分、运动功能评分及肢体缩短情况,并分析影响疗效的相关因素。结果 (1)术后半年髋关节功能评分及运动功能评分均较治疗前显著升高,且肢体缩短情况较治疗前显著改善,P <0.05;(2)行Logistic回归分析可知,年龄<60岁、术前肢体缩短≥2cm、内固定失败后行置换术时间间隔> 4年是影响术后肢体功能恢复的重要因素,P <0.05。结论对髋部骨折内固定失败患者实施全髋关节置换术治疗具有较好的效果,可有效改善患者运动功能,为保证手术效果,术前应综合评估患者年龄、病史、肢体缩短程度等信息,尽早制定手术方案。

Objective To investigate the efficacy and related factors of total hip arthroplasty after failed internal fixation of hip fracture. Methods A total of 48 patients with failed hip fracture internal fixation from January 2015 to June 2018 were randomly selected as observation objects. All hip replacements were performed. The hip function score, motor function score and limb shortening before and after treatment were compared, and the related factors affecting the curative effect were analyzed. Results(1)The hip joint function scores and motor function scores were significantly higher than that before treatment for half a year after the operation, and the limb shortening was significantly improved compared to before treatment, P < 0.05;(2)Logistic regression analysis showed that the age was less than 60 years old, Preoperative limb shortening ≥2 cm, and the time interval between replacement surgery after internal fixation failure>4 years were important factors affecting postoperative limb function recovery, P < 0.05. Conclusions The treatment of total hip arthroplasty for patients with failed hip fracture internal fixation has a good effect, which can effectively improve the patient’s motor function. To ensure the surgical effect, the patient’s age, medical history, and limb shortening should be comprehensively evaluated before surgery. Make a surgical plan as soon as possible.