双极头与全髋置换治疗老年股骨颈骨折的疗效比较

Comparison on effects of bipolar femoral head replacement and total hip rep lacement in treatment of femoral neck fractures in the elderly

目的 比较双极股骨头和全髋关节置换治疗老年股骨颈骨折的效果。 方法 19 93年 8月～ 2 0 0 1年 12月采用双极股骨头或全髋关节置换手术 ,治疗老年股骨颈头下型或经颈型骨折 48例 ,年龄 60～ 85岁 ,平均 70 .8岁。 18例采用双极股骨头置换 ,3 0例采用全髋关节置换。结果 2例死亡 (与手术无关 ) ,1例失访。余 45例平均随访时间为 5年 2个月 ,无一例切口感染和髋关节脱位。全髋置换组髋部和大腿疼痛的发生率为 3 % (1/2 9) ,低于股骨头置换组的发生率 (4/16)。 结论 股骨头置换仅适用于身体虚弱的高龄患者 ,而全髋关节置换适用于多数老年股骨颈骨折患者。

Objective To compare the effects of bipolar femor al head replacement (BFHR) and total hip replacement (THR) in the treatment of femoral neck fractures (FNF) in the elderly. Methods Between August 1993 and December 2001, BFHR or THR were performed in 48 old patients (at age of 60-85 years, mean 70.8 years) with subcapital and transcervical types of FNF. Of all, 18 cases were tre ated with BFHR (Group BFHR) and 30 with THR (Group THR). Results OF all, two patients died (not related to operation), one received no f ollow up and 45 were followed up for average 5 years and 2 months with no wound infection or hip dislocation. Occurrence rate of hip and thigh pains in the Grou p THR was 3% (1/29), lower than that in the Group BFHR (4/16). Conclus ions BFHR is only fit for senile cases with poor physical con dition. However, THR can be used for most old patients with FNF.