经Bikini切口入路下全髋关节置换术治疗股骨颈骨折的效果并发症观察

Observation on Effects and Complications of Total Hip Arthroplasty Via Bikini Incision Approach in the Treatment of Femoral Neck Fractures

目的:探究经Bikini切口入路下全髋关节置换术(THA)治疗股骨颈骨折的效果及并发症状况。方法:选取在2018年9月~2020年9月在某院接受行THA的股骨颈骨折患者共105例,采用随机数字表法分为对照组(52例)和观察组(53例),对照组采用传统外侧切口行THA,观察组采用Bikini切口入路行THA。记录两组患者手术及恢复状况(手术时间、切口长度、髋外展肌力恢复时间、住院时间),比较两组患者术后1周和术后3周、术后3个月、术后12个月时髋关节状况[髋关节功能评分(Harris评分)]及术后3个月内并发症(假体松动、骨折不愈合、切口感染、股骨头坏死)发生率。结果:两组患者切口长度、手术时间比较无统计学差异(P>0.05),观察组髋外展肌力恢复时间、住院时间均短于对照组(P<0.05);术后1周、术后3周及术后3个月时,观察组髋关节状况(Harris评分)高于对照组,术后12个月时,两组Harris评分比较无统计学意义(P>0.05);术后3个月内,观察组并发症总发生率低于对照组(P<0.05)。结论:经Bikini切口入路下THA治疗股骨颈股骨折时能够加快术后髋关节功能恢复进程,具有安全性,值得临床推广。

Objective:To explore the effects and complications of total hip arthroplasty(THA)via Bikini incision approach in the treatment of femoral neck fractures.Methods:105 patients with femoral neck fractures who underwent THA in a hospital from September 2018 to September 2020 were selected and divided into observation group(53 cases)and control group(52 cases)by the random number table method.The control group was given THA via traditional lateral incision,and the observation group was given THA via Bikini incision approach.The surgery and recovery status(surgical time,incision length,hip abductor strength recovery time,hospital stay)of the two groups of patients were recorded.The hip joint status[hip joint function score(Harris score)]at 1 week,3 weeks,3 months and 12 months after surgery and incidence of complications(prosthesis loosening,fracture nonunion,incision infection,femoral head necrosis)within 3 months after surgery were compared between the two groups.Results:There was no significant difference in incision length and surgical time between the two groups of patients(P>0.05),and the recovery time of hip abductor strength and hospital stay in observation group were shorter than those in control group(P<0.05).At 1 week,3 weeks and 3 months after surgery,the hip joint status(Harris scores)of observation group was higher than that of control group,and there was no statistical significance in the Harris score between the two groups at 12 months after surgery(P>0.05).Within 3 months after surgery,the total incidence of complications was lower in observation group than in control group(P<0.05).Conclusion:THA via Bikini incision approach in the treatment of femoral neck fractures can speed up the recovery process of postoperative hip joint function,which is safe and worthy of clinical promotion.