骨水泥型单极与双极人工股骨头置换治疗老年股骨颈骨折

Unipolar versus bipolar hemiarthroplasty with cement for the treatment of the femoral neck fractures in the elderly

目的 :评价骨水泥型单极和双极人工股骨头置换治疗老年股骨颈骨折的疗效。方法 :自 1993年 7月至 2 0 0 2年 5月收治老年股骨颈骨折的病例中 ,选择年龄、性别、随访时间相仿的骨水泥型单极人工股骨头置换术患者 (A组 ) 92例 ,骨水泥型双极人工股骨头置换术患者 (B组 ) 79例 ,进行回顾性分析。结果 :发现两组的住院时间、基本费用、出血量、下地时间、并发症、髋臼磨损及再手术率等差异无显著性 (P >0 0 5 ) ,B组的假体费用较高。随访发现B组步速明显快于A组 ,差异有显著性 (P <0 0 5 )。随访功能优良率 :A组 91 3 % ,B组 92 4% ,差异无显著性 (P >0 0 5 )。结论 :两种方法都是治疗老年股骨颈骨折的有效方法 ,两者无明显差异。骨水泥的应用是必需的。

Objective To evaluate the results of the unipolar versus bipolar hemiarthroplasty with cement for the treatment of the femoral neck fractures in the elderly. Methods 92 patients of the femoral neck fractures treated by cemented unipolar hemiarthroplasty(A group) and 79 patients by cemented bipolar hemiarthroplasty(B group) between 1993 and 2002 were reviewed. Results The results show that the time and the basic expense of hospitalization,blood loss,ambulation time, complication, acetabular rosion and secondary surgery rate were no difference between the two groups (P>0.05). The prosthesis was more expensive and patients had faster walking speeds in the B group (P<0.05). 91.3% of excellent or good function rate in A group, 92.4% in B group, there is no significant difference between the two groups (P>0.05). Conclusion The unipolar and bipolar hemiarthroplasty with cement are the methods in the treatment of the femoral neck fractures in the elderly. The using of the cement is necessary.According to conditions and request of the patients,the two methods are elected respectively.