不同入路小切口髋关节置换术在老年创伤性股骨颈骨折中的临床疗效

Clinical aefficacy of small incision hip arthroplasty with different approaches in elderly patients with traumatic femoral neck fractures

目的探讨不同入路小切口髋关节置换术在老年创伤性股骨颈骨折中的临床疗效。方法选取2016年6月至2020年6月本院收治的60例老年创伤性股骨颈骨折患者作为研究对象,按照随机数字表法分为对照组与研究组,每组30例。对照组给予外侧小切口髋关节置换术进行治疗,研究组给予后路小切口髋关节置换术进行治疗,两组术后均随访12个月,比较两组术后临床疗效、围术期手术指标、手术前后的疼痛程度。结果术后,两组优良率比较差异无统计学意义。研究组术后引流量低于对照组,差异有统计学意义(P<0.05);两组术中出血量及手术时间比较差异无统计学意义。术后,两组VAS、VRS评分低于术前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论后路与外侧小切口髋关节置换术治疗老年创伤性股骨颈骨折的临床疗效相当,但经后路小切口髋关节置换术治疗后,患者术后引流量较少,且疼痛刺激更轻。

Objective To investigate the clinical efficacy of small incision hip arthroplasty with different approaches in elderly patients with traumatic femoral neck fractures.Methods A total of 60 elderly patients with traumatic femoral neck fractures admitted to our hospital from June 2016 to June 2020 were selected as the research subjects,and they were randomly divided into control group and study group using numerical table method,with 30 cases in each group.The control group was treated with lateral small incision hip arthroplasty,while the study group was treated with posterior small incision hip arthroplasty,both groups were followed up for 12 months,the clinical efficacy,perioperative surgical indicators,preoperative and postoperative pain levels between the two groups were compared.Results After surgery,there was no statistically significant difference in the excellent and good rates between the two groups.The postoperative drainage volume in the study group was significantly lower than that in the control group(P<0.05).There was no statistically significant difference between the two groups in intraoperative bleeding volume and surgical time.After surgery,the VAS and VRS scores in the two groups were lower than those before surgery,and the study group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of posterior approach and lateral small incision hip arthroplasty in the treatment of traumatic femoral neck fractures in the elderly is similar,but the postoperative drainage volume of patients undergoing posterior approach small incision hip arthroplasty is lower,and the pain stimulation of the surgery is less severe.