全髋关节置换术与骨折内固定术治疗老年移位型股骨颈骨折的临床效果观察

Clinical effects of total hip arthroplasty and internal fracture fixation in the treatment of displaced femoral neck fractures in the elderly

目的探究全髋关节置换术与骨折内固定术治疗老年移位型股骨颈骨折的临床效果。方法选取100例老年移位型股骨颈骨折患者为研究对象,根据手术方式的不同分为对照组和实验组,每组50例。对照组实施骨折内固定术治疗,实验组实施全髋关节置换术治疗。比较两组治疗前、治疗6个月后疼痛程度、髋关节功能,手术指标、住院时间及并发症发生情况。结果治疗6个月后,两组视觉模拟评分法(VAS)评分均低于本组治疗前,Harris评分高于本组治疗前,且实验组VAS评分(1.26±0.58)分低于对照组的(1.58±0.41)分,Harris评分(87.49±6.03)分高于对照组的(75.64±7.18)分,差异有统计学意义(P<0.05)。实验组术中出血量(187.59±10.98)ml多于对照组的(131.25±11.31)ml,手术用时(113.02±3.69)min长于对照组的(99.15±4.02)nin,下床活动时间(16.35±2.59)d短于对照组的(32.16±4.20)d,差异有统计学意义(P<0.05);两组住院时间比较差异无统计学意义(P>0.05)。实验组并发症总发生率10.00%低于对照组的26.00%,差异有统计学意义(P<0.05)。结论老年移位型股骨颈骨折患者接受全髋关节置换术治疗,可更好降低患者疼痛程度、并发症发生率,缩短康复时间,且可促进患者髋关节功能的改善,意义重大。

Objective To investigate the clinical effects of total hip arthroplasty and internal fracture fixation in the treatment of displaced femoral neck fractures in the elderly.Methods A total of 100 elderly patients with displaced femoral neck fracture were selected for the study,and were divided into control group and experimental group according to different surgical methods,with 50 cases in each group.The control group was treated with internal fracture fixation,and the experimental group was treated with total hip arthroplasty.The pain level and hip function before and after 6 months of treatment,as well as the surgical index,hospitalization time,and occurrence of complications were compared between the two groups.Results After 6 months of treatment,the visual analogue scale(VAS)scores in both groups were lower than those before treatment in this group,and Harris scores were higher than those before treatment in this group;the VAS score(1.26±0.58)points in the experimental group was lower than(1.58±0.41)points in the control group;the Harris score(87.49±6.03)points in the experimental group was higher than(75.64±7.18)points in the control group;the differences were statistically significant(P<0.05).The intraoperative blood loss(187.59±10.98)ml in the experimental group was more than(131.25±11.31)ml in the control group;the operative time(113.02±3.69)min in the experimental group was longer than(99.15±4.02)min in the control group;the off-bed activity time(16.35±2.59)d in the experimental group shorter than(32.16±4.20)d in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in hospitalization time between the two groups(P>0.05).The total complication rate in the experimental group was 10.00%,which was lower than 26.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Total hip arthroplasty in elderly patients with displaced femoral neck fractures is of great significance because it can better reduce the pain level,complication rate,shorten the rehabilitation time,and promote the improvement of hip function.