骨折内固定术、全髋关节置换术治疗老年股骨颈骨折的效果分析

Effect Analysis of Internal Fixation and Total Hip Replacement in Treatment of Senile Femoral Neck Fractures

目的:分析骨折内固定术、全髋关节置换术治疗老年股骨颈骨折的临床效果。方法:将2020年1月—2022年12月湘潭县中医医院骨伤科收治的348例老年股骨颈骨折患者纳入研究,采取双盲法分为对照组(实施骨折内固定术治疗)与研究组(实施全髋关节置换术治疗),每组174例。比较两组手术指标、髋关节功能、静脉血供情况、疼痛情况。结果:研究组手术时间、住院时间短于对照组,骨折愈合时间早于对照组(P<0.05)。术后,两组疼痛、功能、畸形、活动度评分升高,且研究组高于对照组(P<0.05)。术后,两组股静脉血流峰速度、股静脉血流平均速度升高,且研究组高于对照组(P<0.05)。术后1 d、3 d、1周,两组视觉模拟评分法评分降低,且研究组低于对照组(P<0.05)。结论:相较于骨折内固定术,全髋关节置换术治疗老年股骨颈骨折的效果更佳,可有效改善患者髋关节功能、静脉血供,减轻疼痛,加快骨折恢复。

Objective:To analyze the clinical effect of internal fixation and total hip replacement in treatment of senile femoral neck fractures.Methods:A total of 348 elderly patients with femoral neck fractures who were admitted to the Department of Orthopedics and Traumatology at Traditional Chinese Medical Hospital of Xiangtan County from January 2020 to December 2022 were included in the study.Using the double-blind method,the patients were divided into the control group(implementing fracture internal fixation)and the study group(implementing total hip replacement),with 174 cases in each group.The surgical indicators,hip joint function,venous blood supply and pain were compared between the two groups.Results:The operation time and the length of hospital stay in the study group were shorter than those in the control group,and the fracture healing time in the study group was earlier than that in the control group(P<0.05).After surgery,the scores of pain,function,deformity and mobility in the two groups increased,and the scores in the study group were higher than those in the control group(P<0.05).After surgery,the peak velocity of femoral venous blood flow and the average velocity of femoral venous blood flow in the two groups increased,and these indicators in the study group were higher than those in the control group(P<0.05).On 1 d,3 d,and 1 week after surgery,the scores of visual analogue scale in the two groups decreased,and the scores in the study group were lower than those in the control group(P<0.05).Conclusion:Compared with fracture fixation,total hip replacement has a better effect in the treatment of senile femoral neck fractures,and can effectively improve hip joint function and venous blood supply,relieve pain,and accelerate fracture recovery.