全髋置换术和空心钉内固定术治疗股骨颈骨折的疗效比较  

Total hip arthroplasty and cannulated screw fixation of femoral neck fractures

作　　者：于勇 于静 杨家顺 

机构地区：[1]山东省高密市中医院骨一科,山东高密261500 [2]山东省高密市柏城中心卫生院,山东高密261501

出　　处：《中国现代医生》2013年第19期144-145,148,共3页China Modern Doctor

摘　　要：目的比较全髋置换术和空心钉内固定术治疗股骨颈骨折的疗效。方法选择2009年6月～2012年6月我院收治的股骨颈骨折患者70例,其中35例行全髋置换术(观察组),其余35例行空心钉内固定术(对照组)。结果观察组优占42.9%,良占28.6%,可占22.9%,差占5.7%,总有效率达94.3%;对照组优占31.4%,良占22.9%%,可占20.0%,差占25.7%,总有效率达74.3%,两组髋关节功能比较,差异有统计学意义(P<0.05)。观察组患者手术时间达80～105 min,对照组患者的手术时间35～60 min,观察组的平均手术时间明显长于对照组,差异有统计学意义(P<0.01)。观察组患者术中出血量350～460 mL,对照组患者术中出血量100～150 mL,组间比较差异有统计学意义(P<0.01)。观察组患者术后7～12 d下床活动,对照组患者术后20～35 d下床活动,差异有统计学意义(P<0.05)。观察组出现假体松动1例,无一例出现感染、髋关节脱位,对照组出现假体松动2例,髋关节脱位2例,感染1例,骰骨头块死1例,骨折不愈合1例。结论全髋关节置换术和空心钉内固定术治疗股骨颈骨折各具优缺点,其中全髋关节置换术尽管存在操作时间长、创伤大、费用较高的情况,但手术效果好、关节活动度好,适合于多数老年股骨颈骨折患者,值得推广和应用。Objective To compare the total hip replacement surgery and cannulated screw fixation for the treatment of femoral neck fractures. Methods From June 2009 to June 2012 to collect our hospital patients with femoral neck frac- ture 70 cases, of which 35 patients undergoing total hip replacement, the remaining 35 patients cannulated screw fix- ation. Results The excellent 42.9%, good accounted for 28.6%, 22.9%, difference 5.7%, the total effective rate was 94.3%. excellent control group （31.4%）, good in 22.9%, 20.0%, difference 25.7%, the total effective rate was 74.3 %, two sets of hip function compared the efficacy of the observation group was significantly better than the control group, the groups were compared by statistical treatment, the difference was statistically significant （P 〈 0.05）. The patients operative time of 80-105 min, control group of patients with operative time 35-60 min, the average operation time of the observation group was significantly longer than that of the control group, the groups were compared by statistical treatment, the difference was statistically significant （P 〈 0.01 ）. The patients blood loss of 350-460 mL of blood loss in patients of the control group 100 to 150 ml of blood loss of the observation group was significantly longer than the control group, the groups were compared by statistical treatment, the difference was statistically significant （P 〈 0.01）. The patients after 7-12 bed world events on the control group of patients 20-35 world of bed observation group pa- tients get out of bed time was significantly longer than the control group, the groups were compared by statistical treat- ment, the difference was statistically significant （P 〈 0.05）. The observation group prosthesis loosening cases, no case of infection, dislocation of the hip and the control group, the loosening of the prosthesis two cases, dislocation of the hip in 2 cases, 1 case of infection 1 case of femoral head necrosis and 1 case of nonunion. Conclusion Total hip arthroplast

关 键 词：股骨颈骨折 全髋置换术 空心钉内固定术 髋关节功能 

分 类 号：R683.42[医药卫生—骨科学]