3种手术方式治疗中老年股骨颈骨折疗效对比分析  

Comparative study on three operation methods in the treatment of femoral neck fracture in old and middle-aged patients

作　　者：江辉[1] 闫韵飞[1] 赵建宁[1] 

机构地区：[1]第二军医大学南京临床医学院(南京军区南京总医院)骨科,南京医学硕士研究生210002

出　　处：《医学研究生学报》2012年第7期746-748,共3页Journal of Medical Postgraduates

摘　　要：目的股骨颈骨折严重影响中老年人的身心健康和生活质量,探讨半髋关节置换术、全髋关节置换术和切开复位内固定术治疗中老年股骨颈骨折疗效,为治疗此年龄段股骨颈骨折提供临床依据。方法回顾性调查研究161例股骨颈骨折患者的临床资料,其中采用半髋关节置换术56例(A组)、全髋关节置换术45例(B组),切开复位内固定术60例(C组),比较3种手术方式的时间、术中失血量和术后活动下地时间,采用髋关节Harris评分比较不同治疗方式的疗效。结果A、B组的术后下地活动时间显著短于C组(P<0.05),A组术后评分优良率显著高于C组(P<0.05);但C组的手术时间及术中出血量显著少于A、B组(P<0.05)。结论髋关节置换术和切开复位内固定术均为治疗老年人股骨颈骨折的有效措施,建议以个体化医疗为原则,根据骨折类型、患者状况、年龄选择合适手术方式。Objective Femoral neck fracture severely affects the life quality as well as the physical and mental health of old and middle-aged people. This study aimed to compare the clinical effects of hemiarthroplas, total hip arthroplasty, and open reduction and internal fixation in the treatment of femoral neck fracture in old and middle-aged patients. Methods We retrospectively analyzed the clinical data of 161 cases of femoral neck fracture, 77 males aged 53 -70 years and 84 females aged 52 -75 years. Of them, 56 were treated by hemiarthroplas （group A）, 45 by total hip arthroplasty （group B）, and 60 by open reduction and internal fixation （ group C）. We compared the operation time, intraoperative blood loss and postoperative bed time, and observed the results of different surgical methods using Harris scores during 1 - 4 years of follow-up. Results Compared with groups A and B, the operation time and intraoperative blood loss were significantly less （ P 〈 O. 05 ） but the postoperative bed time markedly longer in group C （ P 〈 0.05）. The excellence rate of postoperative Harris scores was remarkably higher in group A than in C （P 〈 O. 05）. Conclusion Hemiarthroplas, total hip arthroplasty, and open reduction and internal fixation are all effective options for the treatment of femoral neck fracture in old and middle-aged patients, which can be selected according to the fracture type, age, and health status of the patients.

关 键 词：半髋关节置换术 全髋关节置换术 切开复位内固定术 股骨颈骨折 

分 类 号：R683.42[医药卫生—骨科学]