老年移位型股骨颈骨折患者治疗中全髋关节置换术与骨折内固定术的临床疗效比较

Clinical Effect and Safety of Total Hip Arthroplasty and Internal Fixation for Displaced Femoral Neck Fractures in Elderly Patients

目的:对比研究老年移位型股骨颈骨折患者治疗中全髋关节置换术与骨折内固定术的临床效果与治疗安全性。方法:本研究选取2017年1月-2018年4月我院收治的146例老年移位型股骨颈骨折患者为对象,随机将其分成置换组和对照组,对比两组患者治疗前后的髋关节功能评分和疼痛评分、手术相关指标以及术后并发症发生情况。结果:治疗前两组的髋关节功能评分和疼痛评分无明显差别(P>0.05),治疗1年后置换组的Harris评分显著高于对照组,McGill评分显著低于对照组(P<0.05);置换组的手术时间和术中出血量高于对照组(P<0.05),两组的住院时间无明显差别(P>0.05);置换组的并发症发生率显著低于对照组(P<0.05)。结论:老年移位型股骨颈骨折患者治疗中使用全髋关节置换术治疗,能够使患者的髋关节功能和疼痛状况得到长效缓解,且术后发生并发症的风险显著低于对照组,其治疗效果和安全性均显著优于内固定治疗方法,适宜广泛应用于临床治疗中。

Objective:To compare the clinical effect and safety of total hip replacement and internal fixation in elderly patients with displaced femoral neck fracture.Methods:146 elderly patients with displaced femoral neck fracture were selected from January 2017 to April 2018 in our hospital.The patients were randomly divided into replacement group and control group.The hip joint function score,pain score,surgical related indexes and postoperative complications were compared between the two groups before and after treatment.Results:There was no significant difference in hip function score and pain score between the two groups before treatment(P>0.05).The Harris score in the replacement group was significantly higher than that in the control group(P<0.05),and the operative time and intraoperative bleeding volume in the replacement group were significantly higher than those in the control group(P<0.05),and there was no significant difference in the hospital stay between the two groups(P>0.05).The incidence of complications in the replacement group was significantly lower than that in the control group(P<0.05).Conclusion:Total hip replacement in elderly patients with displaced femoral neck fracture can relieve the hip function and pain status of the patients for a long time,and the risk of postoperative complications is significantly lower than that of the control group.Group A was superior to internal fixation in efficacy and safety,and was suitable for clinical treatment.