全髋关节置换术与人工双极股骨头置换术治疗老年新鲜移位股骨颈骨折的近期疗效比较  

Comparision of short-term clinical outcome between total hip arthroplasty and bipolar arthroplasty in elderly patients with acute displaced femoral neck fractures

作　　者：张宁[1] 李叔强[1] 李冬松[1] 杨晨[1] 宫宇宝[1] 冯卫[1] 刘建国[1] 

机构地区：[1]吉林大学第一医院,吉林长春130021

出　　处：《中国矫形外科杂志》2011年第4期268-271,共4页Orthopedic Journal of China

摘　　要：[目的]对全髋关节置换术(THA)与人工双极股骨头置换术(BA)治疗伤前活动量大,有独立行走能力的老年新鲜移位股骨颈骨折的疗效进行临床回顾性对比研究。[方法]本科2004年6月～2007年6月期间采用人工关节置换治疗新鲜股骨颈骨折190例,按照一定标准共筛选出完整病例86例,获得随访74例,THA组38例,平均年龄72岁;BA组36例,平均年龄72.5岁,平均随访36个月(18～52个月)。对术中出血量及手术时间、术后并发症及死亡率进行比较,并使用Harris评分和Merled'Aubigne-Postel髋关节功能分级对术后疗效进行评价。[结果]THA组平均手术时间较BA组长,且差别具有显著性(P=0.002),两组术中出血量有显著性差别(P=0.009)。两组术后并发症及死亡率无显著性差别(P=0.500和P=1.000)。THA组术后疼痛、活动范围及行走能力评分均高于BA组,且具有统计学意义(P=0.023,0.006和0.013)。THA组有1例术后出现关节假体脱位,但与BA组相比无统计学意义(P>0.05)。[结论]对术前具有独立行走能力,活动量较大的老年患者实施人工全髋关节置换术早期可获得较好的功能,且术后髋部疼痛发生率低。[Objective] To evaluate the clinical therapeutic effect of total hip arthroplasty （THA） and bipolar arthroplasty （BA） on physiologically active elderly patients with displaced femoral neck fractures.[Method]According to a certain criteria,86 cases were selected from 190 patients with a completed clinical information.Seventy-four cases from these 86 cases were finished the full time follow-up.There were 38 cases in the THA group with the average age of 72.0 year,and 36 cases in the BA group with the average age of 72.5 year.The follow-up period ranged from 18 to 52 months （mean 36months）.Sex distribution,age distribution,cucurrent disease,blood loss,operative time,postoperative complications,mortalities were compared between these two groups.The clinical outcomes of the 2 groups were analyzed using Harris hip scores and the Merled＇ Aubigne-Postel method.[Result]Mean operatie times and blood loss were significantly longer in the THA groups（P=0.002 and P=0.009）,however,there were no significant diffriences between the two groups（p=0.500 and P=0.100）.Pain,mobility and walking ability scores were significantly better in the THA group than in the BA group（P=0.023,0.006 and 0.013）.There was one prosthetic hip dislocation in THA group,but no statistical significance compared to BA group（P0.05）.[Conclusion]The present study suggested that for displaced femoral neck fractures of physiologically active elderly patients,THA group results in less pain and better function than BA group in 3 years follow-up time.

关 键 词：股骨颈骨折 全髋关节置换术 人工双极股骨头置换术 

分 类 号：R687.3[医药卫生—骨科学]