不同入路行全髋关节置换术治疗老年股骨颈骨折的临床疗效

Clinical efficacy of total hip replacement through different approaches in the treatment of femoral neck fracture in the elderly

目的探讨不同入路行全髋关节置换术(THR)治疗老年股骨颈骨折(FNF)的临床疗效。方法选取2018年9月至2020年9月于本院治疗的86例老年FNF患者作为研究对象,按照随机数字表法分为外侧入路组与后外侧入路组,各43例。后外侧入路组采用后外侧入路THR治疗,外侧入路组采用外侧入路THR治疗。比较两组手术指标、髋关节功能及并发症发生情况。结果后外侧入路组手术时间及切口长度均短于外侧入路组,差异有统计学意义(P<0.05);两组术中出血量比较差异无统计学意义。术后1个月,后外侧入路组Harris评分高于外侧入路组,差异有统计学意义(P<0.05);术后6个月,两组Harris评分比较差异无统计学意义。两组并发症发生率比较差异无统计学意义。结论后外侧入路THR治疗老年FNF疗效显著,患者早期髋关节功能恢复良好,且切口小、手术耗时短,但远期疗效与外侧入路行THR治疗相当。

Objective To investigate the clinical efficacy of total hip replacement(THR)through different approaches in the treatment of femoral neck fracture(FNF)in the elderly.Methods 86 elderly patients with FNF who were treated in our hospital from September 2018 to September 2020 were selected as the study subjects,and they were randomly divided into the lateral approach group and the posterior lateral approach group using random number table method,with 43 cases in each group.The posterior lateral approach group was treated with posterior lateral approach THR,while the lateral approach group was treated with lateral approach THR,the surgical indicators,hip joint function,and complications were compared between the two groups.Results The surgical time and incision length in the posterior lateral approach group were shorter than those in the lateral approach group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in intraoperative bleeding between the two groups.1 month after surgery,the Harris score in the posterior lateral approach group was higher than that in the lateral approach group,and the difference was statistically significant(P<0.05);6 months after surgery,there was no statistically significant difference in Harris scores between the two groups.There was no statistically significant difference in the incidence of complications between the two groups.Conclusion The posterior lateral approach for THR treatment of elderly FNF has significant therapeutic effect,the patient's early recovery of hip joint function is good,and the incision is small and the surgical time is short,the long-term efficacy is comparable to that of the lateral approach for THR treatment.