摘要
目的 了解内固定和全髋置换治疗移位股骨颈骨折的疗效。方法 50例65岁以上有移位的股骨颈骨折病人,随机分成两组,一组为透视下闭合复位三枚平行空心螺钉内固定,另一组行全髋置换术。有精神障碍共19例。结果 全髋置换组术后1年内Harris髋关节评分优于内固定组,而病死率两组无差异。有精神障碍者全髋置换术后并发症多与内固定组。分别为32％及5％,在精神正常者则相反,分别为12％和60％。2年病死率在有精神障碍者为8/19,精神正常者为3/31(P<0.001)。结论 对有错位的股骨颈骨折的老年患者,若精神正常或对功能恢复要求较高,应行全髋置换术。
Objective To compare the results of treatment of displaced femoral neck fractures with internal fixation and total hip replacement. Methods Fifty patients (age 65 - 91, mean age 74) with displaced femoral neck fractures were randomly assigned to two group, osteosynthesis with three parallel screws inserted percutaneously and total hip arthroplasty. Nineteen patients had mental dysfunction. Results In 1 year postoperative, the Harris hip scores of arthroplasty group were significantly better than osteosynthesis group. The mortality rate had no differience. Mental dysfunction patients, rate of complication in arthroplasty group was 32% , more than osteosynthesis group (5%), whereas normal mental patients, rate of complication was 12% and 60%. Conclusion Total hip arthroplasty should be considered for old patients who suffers from a displaced femoral neck fracture with normal mental function and high functional demands.
出处
《骨与关节损伤杂志》
2003年第11期727-729,共3页
The Journal of Bone and Joint Injury
