直接上方入路与后外侧入路在老年股骨颈骨折半髋置换术中的早期疗效比较

Early Efficacy of Direct Upper Approach and Posterolateral Approach in Semi-hip Replacement for Femoral Neck Fracture in Elderly Patients

目的探究半髋置换术经直接上方入路与后外侧入路方式在老年股骨颈骨折中的手术效果。方法随机选取2022年1—12月山西省平遥县人民医院拟接受半髋置换术的80例老年股骨颈骨折患者为研究对象,依据不同入路方式分为对照组(后外侧入路)与研究组(直接上方入路),每组40例。对比两组患者手术指标、髋关节功能与并发症发生情况。结果研究组术中出血量少于对照组,手术时间、术后初次下地时间及住院时间均短于对照组,差异有统计学意义(P均<0.05)。术前及术后3个月,两组患者Harris髋关节评分系统中各项评分比较,差异无统计学意义(P均>0.05);术后1个月,研究组Harris髋关节评分系统中功能评分与总分高于对照组,差异有统计学意义(P均<0.05)。研究组并发症总发生率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(χ2=4.114,P=0.043)。结论老年股骨颈骨折患者应用直接上方入路半髋置换术手术指标优于后外侧入路,可提高髋关节功能,减少并发症的发生。

Objective To explore the effect of direct upper approach and posterolateral approach in the treatment of femoral neck fracture in elderly patients with semi-hip replacement.Methods A total of 80 elderly patients with femoral neck fracture who were to receive semi-hip replacement in Pingyao County People's Hospital of Shanxi Province from January to December 2022 were randomly selected as the study subjects.According to different approaches,they were divided into control group(posterolateral approach)and study group(direct upper approach),with 40 cases in each group.The operative indexes,hip function and complications were compared between the two groups.Results The amount of blood loss in the study group was less than that in the control group,and the time of operation,the time of initial postoperative landing and the time of hospitalization were shorter than that in the control group,the differences were statistically significant(all P<0.05).Before surgery and 3 months after surgery,there was no significant difference between the two groups in the Harris Hip Scoring System(all P>0.05);One month after surgery,the functional score and total score of Harris Hip Scoring System in the study group were higher than those in the control group,and the differences were statistically significant(both P<0.05).The total incidence of complications in the study group was 5.00%(2/40),which was lower than that in the control group 20.00%(8/40),and the difference was statistically significant(χ2=4.114,P=0.043).Conclusion In elderly patients with femoral neck fracture,direct upper approach is superior to posterolateral approach,which can improve hip function and reduce the incidence of complications.