老年新鲜移位股骨颈骨折的手术治疗分析  

Comparative study of operations in treating displaced femoral neck fractures in the elderly

作　　者：李杰[1] 周春晖[1] 刘文华[2] 刘儒森[2] 张彦芳[1] 

机构地区：[1]山东省烟台市莱阳中心医院骨科,265200 [2]山东省潍坊医学院附属院骨科,264200

出　　处：《中国矫形外科杂志》2009年第14期1065-1067,共3页Orthopedic Journal of China

摘　　要：[目的]探讨内固定、人工股骨头置换和全髋置换在治疗老年人移位性股骨颈骨折中的价值。[方法]对2003年6月-2008年5月收治的95例65岁以上新鲜移位性股骨颈骨折患者进行随访研究,比较闭合复位内固定、人工股骨头置换和全髋置换术在手术时间、出血量、住院时间、术后1年和3年的功能评价、并发症以及二次手术率方面的差异。[结果]随访时间12～36个月,平均26个月。闭合复位内固定组的手术时间、失血量、住院时间均为最低(P<0.05),但卧床时间最长,并发症和手术翻修率最高,术后3年随访功能最差。全髋置换术卧床时间短,并发症和手术翻修率低,术后髋关节功能最好,但手术创伤较大,对患者身体一般状况要求较高。人工股骨头置换的手术创伤比全髋置换稍小,但并发症发生率、手术翻修率较高,术后功能比全髋置换差。[结论]关节置换是治疗老年移位性股骨颈骨折的有效手术方法。[ Objective ] To explore the value of different surgical methods in the treatment of the displaced femoral neck fracture in the elderly. [ Method] A follow up study was done on 95 eases older than 65 years who were treated with internal fixation, femoral head arthroplasty and total hip joint replacement from 2003 to 2008. The differenee upon operation time, blood loss, duration of hospitalization ,joint function evaluation one and two years after operation, complications and reoperation rate were compared. [ Result] The internal fixation group bad the shortest operation time and hospitalization and the least blood loss but the highest immobilization time, highest co-mplieation rate and reoperation rate as well as the worst joint function. While the total hip joint replacement group had the least immobilization time, the lowest eompliction rate and reoperation rate, best joint function but required better health condition. The femoral head arthroplasty group had the least operation injury but had relative higher reoperation rate and worse joint function compared to the total hip joint replacement group. [ Conclusion] Prosthetic replacement is reliable to treat femoral neck fractures in the elderly.

关 键 词：股骨颈骨折 老年 全髋关节置换 股骨头置换 

分 类 号：R687.3[医药卫生—骨科学]