后外侧微创入路行全髋关节置换术治疗老年股骨颈骨折的早期疗效

Analysis of early efficacy of total hip arthroplasty through posterolateral minimally invasive approach for elderly femoral neck fractures

目的分析后外侧微创入路行全髋关节置换术治疗老年股骨颈骨折的方法、效果及骨代谢、血液流变学变化。方法根据随机数表法,将2019年1月至2021年7月在本院行全髋关节置换术治疗的98例老年股骨颈骨折患者分为观察组和对照组,每组各49例。对照组采用后外侧常规入路,观察组采用后外侧微创入路。比较两组患者临床指标、疼痛程度和髋关节功能、骨代谢指标、血液流变学指标、平衡功能以及并发症发生率。结果相比对照组,观察组切口较小,术中出血量较少,术后首次下床时间以及住院时间均较短(P<0.05);治疗后相比对照组,观察组疼痛程度较低,髋关节功能较好(P<0.05);治疗后观察组骨代谢改善情况、血液流变学各项指标改善情况均比对照组较好(P<0.05);治疗后观察组平衡功能相比对照组较高(P<0.05);两组并发症发生率对比差异无统计学意义(P>0.05)。结论经后外侧微创入路行全髋关节置换术治疗老年股骨颈骨折,效果显著,可有效缓解患者痛苦,改善骨代谢,促进血液循环,利于髋关节功能的恢复,减轻机体平衡功能障碍。

Objective To analyze the method,effect,bone metabolism and hemorheology of posterolateral minimally invasive total hip arthroplasty for femoral neck fracture in the elderly.Methods According to the random number table method,98 elderly patients with femoral neck fracture who underwent total hip arthroplasty in our hospital from January 2019 to July 2021 were divided into observation group and control group,with 49 cases in each group.Posterolateral conventional approach was used in the control group and posterolateral minimally invasive approach was used in the observation group.The clinical indexes,pain degree,hip function,bone metabolism,hemorheology,balance function and complication rate were compared between the two groups.Results Compared with the control group,the observation group had smaller incision,less intraoperative bleeding,shorter first time out of bed and shorter hospital stay(P<0.05);After treatment,compared with the control group,the observation group had lower pain and better hip function(P<0.05);After treatment,the improvement of bone metabolism and hemorheological indexes in the observation group were better than those in the control group(P<0.05);After treatment,the balance function of the observation group was higher than that of the control group(P<0.05);There was no significance between the two groups when compared the incidence of complication(P>0.05).Conclusion Total hip arthroplasty through posterolateral minimally invasive approach was effective for elderly femoral neck fractures.It could effectively alleviate the pain of patients,improve bone metabolism,promote blood circulation,facilitate the recovery of hip function and reduce the dysfunction of body balance.