摘要
目的 比较新鲜与陈旧性股骨颈骨折行全髋关节置换术 (THR)后的近期疗效。 方法 对 1997年 1月～ 1999年 10月在我科行首次THR的股骨颈骨折患者进行二次随访 ,间隔时间13个月。 结果 取得了 47例完整资料 ,随访时间 3 7～ 62个月 ,平均 44个月。患者年龄 (61.80± 5.2 2 )岁 (41～ 77岁 ) ;术前Harris评分 (2 8.40± 10 .14 )分 ,术后Harris评分 (85.2 0± 7.91)分。新鲜股骨颈骨折组由术前 (2 1.60± 8.73 )分恢复到术后 (82 .50± 9.81)分 [(63 .50± 5.53 )岁 ] ;陈旧性股骨颈骨折组由 (3 7.70± 13 .50 )分恢复到 (90 .63± 5.79)分 [(58.90± 7.81)岁 ]。本组病例中 1例(2 % )术后 6周内功能锻炼时曾出现 1次假体脱位 ,手法复位后未再发生 ;1例 (2 % )于术后 3年摔伤发生股骨干骨折 ,骨折前功能评定优良 ,行钢缆内固定术后功能恢复良好 ;其他病例无并发症发生。陈旧性股骨颈骨折组Harris评分明显高于新鲜骨折患者 (P <0 .0 5) ,分类评分中疼痛评分明显偏高。 结论 THR对中老年股骨颈骨折患者的短期疗效良好 ;陈旧性股骨颈骨折THR术后疼痛症状明显缓解 ;而新鲜骨折疼痛评分相对较低。
Objective To compare the short-term follow-up cu ra tive effect of primary total hip replacement (THR) in treating fresh and old fem oral neck fractures. Methods Double follow-ups with an in terval of 13 months were performed in patients with femoral neck fractures under going THR in our department from January 1997 to October 1999. Results After a follow-up for 37-62 months (mean 44 months), we obtained f ull data of 47 patients [41-77 years old, (61.8±5.22) years old] with preoperative Harris score of 28.40±10.14 and postoperative score of 85.20±7. 91. The Harris score of patients with fresh femoral neck fractures (FFNF) incr eased from 21.60±8.73 preoperatively to 82.50±9.81 postoperatively〔at age of (63.50±5.53) years〕 and that of patients with old femoral neck fracture (O FNF) from 37.70±13.50 to 90.63±5.79, [at age of (58.90±7.81) years]. Of 47 patients, only one case had dislocation once within six weeks postoperative ly during function exercise and recovered after manual reduction. Another one wi th excellent function evaluation was given again internal fixation three years a fter THR because of femoral shaft fracture and obtained satisfactory recovery. N o complications were found in other patients. The mean Harris score in patients with OFNF was significantly higher than those with FFNF ( P <0.05). Harris pai n score was significantly high. Conclusions In the middle -aged and relatively old people with femoral neck fractures, THR has a good the rapeutic effect in short-term follow-up and markedly relieve pain in patients with OFNF. Harris score is rather low in patients with FFNF. However, a large nu mber of THR cases are needed to ascertain the present conclusion.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第11期658-661,共4页
Chinese Journal of Trauma
