THA与HA治疗老年移位型股骨颈骨折的远期效果及对患者髋关节功能的影响

Long-term effect of THA and HA on elderly patients with displaced femoral neck fracture and its influence on hip function

目的分析全髋关节置换术(THA)与半髋关节置换术(HA)治疗老年移位型股骨颈骨折的远期效果及对患者髋关节功能的影响。方法抽取2017年1月至2017年12月于鹤煤集团有限责任公司总医院行THA治疗的43例老年移位型股骨颈骨折患者纳入THA组,另抽取同期接受HA治疗的43例老年移位型股骨颈骨折患者纳入HA组,回顾性分析其临床资料。比较两组手术相关指标,比较两组术后6个月、12个月、2年及3年的髋关节功能恢复情况及术后并发症发生情况。结果本研究纳入的86例老年移位型股骨颈骨折患者均未失访,随访时间36~48(41.25±5.24)个月。HA组手术时间短于THA组,术中出血量及住院费用少于THA组,差异有统计学意义(P<0.05)。THA组术后2、3年髋关节Harris评分高于HA组,差异有统计学意义(P<0.05)。HA组髋部疼痛发生率(18.60%,8/43)高于THA组(4.65%,2/43),差异有统计学意义(P<0.05)。结论THA与HA在老年患者移位型股骨颈骨折治疗中均有各自优、缺点,与HA相比,THA的远期效果更好,更利于维持髋关节功能的长期稳定。

Objective To analyze the long-term effect of total hip arthroplasty(THA)and hip arthroplasty(HA)in the treatment of displaced femoral neck fracture in the elderly,and the influence on hip function.Methods A total of 43 elderly patients with displaced femoral neck fracture who were treated by THA in General Hospital of Hebi Coal Industry(Group)Co.,Ltd from January 2017 to December 2017 were included in the THA group;another 43 elderly patients with displaced femoral neck fracture who received HA treatment in the same period were included in HA group.The clinical data of the two groups were retrospectively analyzed.The operation related indexes of the two groups were compared,and the recovery of hip joint function and postoperative complications 6 months,12 months,2 years and 3 years after operation were compared between the two groups.Results In this study,86 elderly patients with displaced femoral neck fracture were included without loss of follow-up,the follow-up time was 36-48(41.25±5.24)months.The operation time of HA group was shorter than that of THA group,the intraoperative blood loss and hospitalization expenses in HA group were less than those in THA group,and the difference was statistically significant(P<0.05).The Harris scores of hip joint 2 and 3 years after operation in THA group were higher than those in HA group,and the difference was statistically significant(P<0.05).The incidence of hip pain in HA group(18.60%,8/43)was higher than that in THA group(4.65%,2/43),and the difference was statistically significant(P<0.05).Conclusions Both THA and HA have their own advantages and disadvantages in the treatment of elderly patients with displaced femoral neck fracture.Compared with HA,THA has a better long-term effect,and is more conducive to maintaining the long-term stability of hip joint function.