摘要
目的 探讨内固定术与人工髋关节置换术治疗老年性股骨颈骨折的术式选择。 方法 回顾性分析 1996年 1月～ 1999年 6月收治的 6 0岁以上股骨颈骨折患者 74例 ,其中A组(内固定组 ) 2 9例 ,B组 (人工髋关节组 ) 4 5例。两组的年龄、骨折分型、术前全身状况相仿。随访 2 5～ 6 5个月 ,平均 37.3个月。 结果 A组平均住院日及手术持续时间均较短 ,出血量少 ,费用低。骨折愈合率 93.1% (2 7 2 9) ,股骨头坏死率 2 7.6 % (8 2 9)。需再次手术行髋关节置换术 9例 ,再手术率为 31.0 %。B组需翻修手术的 5例 ,再手术率为 11.1% ,关节功能优于A组 [优良率A组 6 2 .1%(18 2 9) ,B组 84 .4 % (38 4 5 ) ]。 结论 GardenⅠ、Ⅱ、Ⅲ型的 70岁以下老年性股骨颈骨折患者 ,在优良复位的前提下可先予坚强的内固定治疗 ,Ⅰ期髋关节置换术适合于高龄及移位严重的患者。
Objective To explore the surgical methods in treatment of femoral neck fractures in the elderly patients. Methods Seventy four patients (over 60 years old) with femoral neck fractures who underwent either internal fixation or arthroplasty from January 1996 to June 1999 were analyzed retrospectively, of which 29 cases were with internal fixation (Group A)and 45 with arthroplasty (Group B). Two groups were similar in age, fracture classification and preoperative health condition. The average follow up was 37.3 months (25 65 months). Results The patients in the Group A had less blood loss, spent less and needed shorter hospitalization and operative duration. Healing rate of femoral neck fractures was 93.1%(27/29), avascular necrosis rate of femoral head 27.6% (8/29) and re operation rate 31.0% (9/29). In the Group B, the re operation rate of arthroplasty was 11.1% (5 cases), and excellence rate of the joint function was 84.4% (38/45) but it was 62.1% (18/29) in the Group A. Conclusions When treating femoral neck fracture of GardensⅠ, Ⅱor Ⅲ in the elderly (60 70 years old), internal fixation should be the first choice, and arthroplasty is suitable for the patients older than 70 years or those with the severely displaced fractures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2002年第4期232-234,共3页
Chinese Journal of Trauma
基金
广州市科委重点攻关计划资助项目 (98-2 -0 99-0 1)
