常前入路人工髋关节置换术治疗股骨颈骨折临床效果及X线检查对患者预后的随访分析

Clinical effect of anterior hip arthroplasty in the treatment of femoral neck fracture and follow-up analysis of X-ray examination on the prognosis of patients

目的探讨前入路人工髋关节置换术(THA)治疗股骨颈骨折的临床效果及X线对患者预后的随访分析效果。方法选取2018年1月至2020年1月在我院行THA的110例股骨颈骨折患者为研究对象,按照随机数字表法分为A组和B组,每组55例。A组行前入路THA,B组行前外侧入路THA。采用视觉模拟疼痛评分(VAS)评估2组患者术后疼痛,并采用起立行走计时测试(TUG)评估患者术后行走情况。术后2组患者均随访3个月时间,采用X线检查评估预后情况。结果术后1 d、术后1周,A组VAS评分低于B组,差异有统计学意义(P<0.05)。术后1周,2组TUG时间比较差异无统计学意义(P>0.05),但术后1个月、术后3个月,A组TUG时间短于B组,差异有统计学意义(P<0.05)。术后3个月内,A组骨折线错位、骨折脱位、附件骨折及嵌入式骨折的总发生率低于B组,差异有统计学意义(P<0.05)。结论前入路THA可有效减轻股骨颈骨折患者术后疼痛,改善患者行走情况,并且应用X线检查有助于随访患者预后情况。

Objective To explore the clinical effect of anterior total hip arthroplasty(THA)in the treatment of femoral neck fracture and the follow-up analysis of X-ray prognosis.Methods One hundred and ten patients with femoral neck fracture who underwent THA in our hospital from January 2018 to January 2020 were selected as the research objects.They were randomly divided into group A and group B,with 55 cases in each group.Group A underwent anterior approach THA and group B underwent anterolateral approach THA.Visual analogue pain scale(VAS)was used to evaluate the postoperative pain of the two groups,and the standing walking timing test(TUG)was used to evaluate the postoperative walking of the patients.The patients in both groups were followed up for 3 months,and the prognosis was evaluated by X-ray examination.Results One day and one week after operation,the VAS score of group A was lower than that of group B(P<0.05).One week after operation,there was no significant difference in tug time between the two groups(P>0.05),but 1 month and 3 months after operation,the tug time in group A was shorter than that in group B(P<0.05).Within 3 months after operation,the total incidence of fracture line dislocation,fracture dislocation,accessory fracture and embedded fracture in group A was lower than that in group B(P<0.05).Conclusion Anterior approach THA can effectively reduce postoperative pain and improve walking of patients with femoral neck fracture,and X-ray examination is helpful to follow up the prognosis of patients.