后路小切口人工全髋关节置换治疗老年人股骨颈骨折  

Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fracture in the aged people

作　　者：祝海炳 蒋垚[2] 龙亨国 沈灏[2] 刘玖行 

机构地区：[1]舟山市骨伤医院骨科,浙江舟山316000 [2]上海交通大学附属第六人民医院骨科

出　　处：《中国骨伤》2007年第9期594-596,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察后路小切口人工全髋关节置换术(小切口-THA)治疗老年股骨颈骨折的临床效果。方法:本组24例65岁以上股骨颈骨折患者,女13例,男11例;年龄65～78岁,平均73.4岁。均为外伤后股骨颈头下型骨折,位线差,其中Garden分型为Ⅲ型10例,Ⅳ型14例,全部应用后路小切口技术行全髋关节置换术。结果:术后所有病例随访10～24个月,平均13个月。平均手术时间80min,手术切口平均长8.0cm,平均输血300ml,无局部及全身并发症出现。按UCLA(UniversityofCaliforniaLosAngeles)髋关节功能评分标准,本组UCLA评分由术前平均(11.0±3.8)分升至术后平均(24.3±4.5)分(P<0.01)。本组优17例,良4例,一般3例,优良率为87.5%。结论:后路小切口技术具有创伤小、出血少、恢复快的特点,可获得与常规后路相同的治疗效果,尤其适合老年股骨颈骨折患者。Objective： To obaserve the therapeutic results of total hip arthroplasty （THA） with posterior minimal incision for the treatment of femoral neck fractures in the aged people. Methods： Twenty-four patients with femoral neck fractures were treated in the study, among which 13 patients were female and 11 patients were male, ranging in age from 65 to 78 years,with an average of 73.4 years. All the fractures were subcapital type with bad location of the fracture line,which were caused by trauma. According to Garden classification, 10 patients were type Ⅲ fracture, 14 patients were type IV fracture. All the patients were treated with posterior minimally invasive total hip arthroplasty. Results： All the patients were followed up. The average duration of follow-up was 13 months （range, 10 to 24 months）. The average duration of the operation was 80 minutes. The average length of incision was 8.0 cm. The average blood transfusion was 300 ml. No complications occurred. The therapeutic effects were evaluated based on UCLA （University of California Los Angeles） hip score. The average UCLA scores of all the patients elevated from 11.0± 3.8 preoperatively to 24.3 ±4.5 postoperatively （P 〈 0. 01 ）. Seventeen patients obtained an excellent result,4 good,3 bad. The excellent and good rate was 87.5%. Conclusion： THA with posterior minimal incision has the advantages of less soft tissue damage, less blood loss and faster recovery, which can improve hip joint function as good as that of traditional posterior approach, especially good for the elderly patients with femoral neck frac- tures.

关 键 词：关节成形术 置换  髋 外科手术 微创性 股骨颈骨折 老年人 

分 类 号：R684.3[医药卫生—骨科学]