保留梨状肌和部分关节囊的人工双极髋关节置换术对老年性股骨颈移位型骨折的治疗效果

Effectiveness of Artificial Bipolar Hip Arthroplasty with Preservation of the Pear-shaped Muscle and Part of the Joint Capsule for Aged Displaced Femoral Neck Fractures

目的:探讨保留梨状肌和部分关节囊的人工双极髋关节置换术对老年性股骨颈移位型骨折的治疗效果。方法:选取2020年1月—2022年12月贵州省铜仁市人民医院关节外科收治的老年股骨颈骨折患者40例为观察对象,按随机数字表法分为试验组与对照组,各20例。试验组给予保留梨状肌和部分关节囊的人工双极髋关节置换术治疗,对照组给予不保留梨状肌和部分关节囊的人工双极髋关节置换术治疗。比较两组患者髋关节功能、手术时间与术中出血量、并发症发生率。结果:术后1、3、6个月,两组患者髋关节评分系统(Harris)评分均升高,试验组高于对照组,差异有统计学意义(P<0.05)。试验组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。试验组并发症发生率低于对照组,差异有统计学意义(P<0.001)。结论:保留梨状肌和部分关节囊的人工双极髋关节置换术治疗老年性股骨颈移位型骨折的效果确切,可最大限度减轻术中创伤,保留机体原有生理结构,加速髋关节功能恢复,降低并发症发生率。

Objective:To investigate the therapeutic effect of artificial bipolar hip arthroplasty with preservation of the pear-shaped muscle and part of the joint capsule on elderly displaced femoral neck fractures.Methods:Forty elderly patients with displaced femoral neck fracture admitted to the Department of Joint Surgery,Tongren People's Hospital from January 2020 to December 2022 were selected as observation subjects and divided into a test group and a control group according to the random number table method,with twenty cases each.The test group was treated with artificial bipolar hip arthroplasty with preservation of the pear-shaped muscle and part of the joint capsule.The control group was treated with artificial bipolar hip arthroplasty without preserving the pear-shaped muscle and part of the joint capsule.The hip function,operation time and intraoperative bleeding,and complication rate of the two groups were compared.Results:At 1,3 and 6 months after surgery,the hip scoring system(Harris)scores of both groups increased,and the test group was higher than the control group,and the difference was statistically significant(P<0.05).The operation time of the test group was shorter than that of the control group,and the intraoperative bleeding was less than that of the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the test group was lower than that in the control group,and the difference was statistically significant(P<0.001).Conclusion:Artificial bipolar hip arthroplasty with preservation of the pear-shaped muscle and part of the joint capsule is effective in treating displaced femoral neck fractures in the elderly,minimizing intraoperative trauma,preserving the original physiological structure of the body,accelerating the recovery of hip function,and reducing the incidence of complications.