不同入路全髋关节置换术在老年股骨颈骨折患者中的应用效果比较

Comparison on the Application Effects of Different Approaches for Total Hip Arthroplasty in Elderly Patients with Femoral Neck Fracture

目的比较不同入路全髋关节置换术在老年股骨颈骨折患者中的应用效果。方法回顾性分析2018年10月至2020年10月我院收治的64例老年股骨颈骨折患者的临床资料,将采用微创直接前入路(DAA)全髋关节置换术治疗的32例患者纳入观察组,采用后外侧入路全髋关节置换术治疗的32例患者纳入对照组,比较两组的手术相关指标以及髋关节功能Harris评分。结果观察组的手术时间长于对照组,但切口长度、术后首次下床活动时间均短于对照组(P<0.05)。术后6个月,两组的Harris评分均高于术前,且观察组的Harris评分高于对照组(P<0.05)。结论与后外侧入路全髋关节置换术相比,微创DAA全髋关节置换术治疗老年股骨颈骨折虽手术时间较长,但创伤较小,能更有效地促进患者髋关节功能恢复。

Objective To compare the application effects of different approaches for total hip arthroplasty in elderly patients with femoral neck fracture.Methods The clinical data of 64 elderly patients with femoral neck fracture admitted to our hospital from October2018 to October 2020 were retrospectively analyzed.32 patients treated with total hip arthroplasty through minimally invasive direct anterior approach(DAA)were selected as the observation group,and 32 patients treated with total hip arthroplasty through posterolateral approach were selected as the control group.The surgery-related indicators and Harris score of hip joint function were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,but the length of incision and the first out-of-bed activity time after surgery were shorter than those in the control group(P<0.05).6 months after surgery,the Harris scores in both groups were higher than those before surgery,and the Harris score in the observation group was higher than that in the control group(P<0.05).Conclusions Compared with total hip arthroplasty through posterolateral approach,total hip arthroplasty through minimally invasive DAA in the treatment of elderly patients with femoral neck fracture has longer operation time,but it has smaller trauma and can more effectively promote the recovery of hip joint function.