摘要
目的评价全髋关节置换术(THA)和人工股骨头置换术(HA)治疗老年移位性股骨颈骨折的效果。方法对54例伤前活动良好的移位性股骨颈骨折患者分别采用THA(27例)和HA(27例)治疗,比较手术时间、术中出血量、术后引流量、并发症发生情况及疗效。结果 54例均获随访,时间12～24(15±2.6)个月。THA组:手术时间50～120(86±33)min,术中出血量200～500(380±125)ml,术后引流量450～610(510±83)ml;HA组:手术时间30～55(43±10)min,术中出血量70～120(95±20)ml,术后引流量100～140(112±18)ml。THA组上述指标均优于HA组(P<0.01)。THA组优良率92.6%,单次步行最大距离1.7km;HA组优良率为66.7%,单次步行最大距离0.5 km;THA组的术后功能明显优于HA组(P<0.05)。两组术后并发症无明显差别,而HA组中有20例术后随访发现髋臼侧不同程度的磨损。结论老年移位性股骨颈骨折行THA可以获得更好的短期临床效果,而术后并发症并不会明显增加。
Objective To evaluate the role of total hip arthroplasty （THA） and hemiarthroplasty （HA） in patients with displaced fractures of the femoral neck. Methods In the retrospectively study, fifty-four patients who had been mobiled and lived independently before they had sustained a displaced fracture of the femoral neck received either a THA or a HA. Clinical outcome was assessed by the Harris hip score, and postoperative complications were recor- ded. Results The mean blood loss was significantly less in the HA group 70 ～ 120 （95 ± 20） ml compared to the THA group 200 ～500 （380 ± 125） ml. The operative time in THA group 50 ～ 120（86 ±33） min was longer than that in HA group 30 ～ 55 （43 ±10） min. However, after a follow up of mean duration of fifteen months, there were 25 ex- cellent or good cases（92.6% ） in THA group and 18 excellent or good cases（66. 7% ） in the HA group. The mean walking distance was 0.5 km for the HA group and 1.7 km for the THA group. Patients in the T/-IA group walked far- ther and had a better Harris hip score （ P 〈 0. 05 ） than those in the HA group. There were no significant differences in the rates of postoperative complication or dislocation between THA group and HA group. Twenty of twenty-seven patients in the HA group had radiographic evidence of aeetabular erosion at the time of the final follow-up. Conclu- sions Total hip arthroplasty provides superior short-term clinical results and no more complications when compared with hemiarthroplasty in this retrospectively study of patients with displaced fractures of the femoral neck.
出处
《临床骨科杂志》
2012年第6期681-683,共3页
Journal of Clinical Orthopaedics
