内固定术与髋关节置换术治疗老年股骨颈骨折的效果比较

Comparison of Effect of Internal Fixation and Hip Replacement in the Treatment of Senile Femoral Neck Fractures

目的:比较内固定术与髋关节置换术治疗老年股骨颈骨折的效果。方法:选取2020年3月—2022年3月当阳市人民医院收治的135例老年股骨颈骨折患者作为研究对象,随机分为内固定组(n=65)与置换组(n=70)。内固定组实施内固定术,置换组实施髋关节置换术。比较两组手术相关指标、髋关节功能、并发症发生情况、股静脉血流、生活质量。结果:置换组手术用时、住院时间和骨折愈合时间短于内固定组,差异有统计学意义(P<0.001)。术后1、6个月,两组髋关节功能评分及股静脉血流峰速度、平均速度逐渐升高,且置换组高于内固定组,差异有统计学意义(P<0.05)。术后6个月,两组生活质量评分高于术前,且置换组高于内固定组,差异有统计学意义(P<0.05)。置换组并发症总发生率低于内固定组,差异有统计学意义(P=0.029)。结论:相较于内固定术,髋关节置换术治疗老年股骨颈骨折的效果更优,可缩短住院和骨折愈合时间,改善患者髋关节功能及生活质量,减少并发症。

Objective:To compare the effect of internal fixation and hip replacement in the treatment of senile femoral neck fracture.Methods:A total of one 135 elderly patients with femoral neck fracture admitted to Dangyang People's Hospital from March 2020 to March 2022 were selected as the study objects,and randomly divided into internal fixation group(n=65) and replacement group(n=70).Internal fixation was performed in the internal fixation group and hip replacement was performed in the replacement group.The operative indexes,hip function,complications,femoral vein blood flow and quality of life were compared between the two groups.Results:The operation time,hospital stay and fracture healing time in the replacement group were shorter than those in the internal fixation group,and the differences were statistically significant(P<0.001).At 1 and 6 months after surgery,hip function score and femoral vein blood flow peak velocity and average velocity were gradually increased in the two groups,and the replacement group was higher than the internal fixation group,the difference was statistically significant(P<0.05).Six months after surgery,the quality of life score of the two groups was higher than that before surgery,and the replacement group was higher than the internal fixation group,the difference was statistically significant(P<0.05).The total complication rate of the replacement group was lower than that of the internal fixation group,and the difference was statistically significant(P=0.029).Conclusion:Compared with internal fixation,hip replacement is more effective in the treatment of elderly femoral neck fractures,which can shorten hospitalization and fracture healing time,improve hip function and quality of life of patients,and reduce complications.