全髋关节置换和全髋关节表面置换治疗髋臼骨折术后继发性创伤性关节炎患者的临床对比分析  

Clinical comparative analysis of THR and HRA in the treatment of patients with post-traumatic arthritis after surgery of acetabular fracture

作　　者：张新雄 ZHANG Xin-wei(Anyue People’s Hospital,Anyue 642350,China)

机构地区：[1]四川省安岳县人民医院,四川安岳642350

出　　处：《实用医院临床杂志》2019年第3期171-173,共3页Practical Journal of Clinical Medicine

摘　　要：目的对比全髋关节置换(THR)和全髋关节表面置换(HRA)治疗髋臼骨折术后继发性创伤性关节炎的临床疗效。方法我院收治的42例髋臼骨折术后继发性创伤性关节炎患者,据治疗方式不同分为HRA组和THR组各21例。比较两组后髋关节评分(Harris)、髋关节活动度、并发症发生率。结果两组术后1月、3年Harris评分较术前明显提高(P <0. 05),但两组间比较,差异无统计学意义(P> 0. 05)。HRA组优10例,良6例,优良率72. 72%,THR组优8例,良7例,优良率75. 00%。两组术后3年髋关节外展、屈曲、内旋、内收、外旋均较术前升高(P <0. 05),但两组间比较,差异无统计学意义(P>0. 05)。两组术后感染率、关节脱位、血管神经损伤、深静脉血栓率比较,差异无统计学意义(P> 0. 05)。结论 THR适用于骨缺损更为严重的患者,而对于部分患者具备选用HRA进行治疗,能有效为患者保留骨量,为术后运动和生存质量有明显帮助。Objective To compare the clinical efficacy between THR and HRA in the treatment of patients with post-traumatic arthritis after surgery of acetabular fracture.Methods The clinical data of 42 patients with post-traumatic arthritis after surgery of acetabular fracture were retrospectively analyzed.The patients were divided into total hip resurfacing group( HRA) and total hip replacement group( THR) according to different treatment methods,21 in each group.Harris scores,activity of hip joint,and incidence of complication were compared between the two groups before and after surgery.Results The Harris scores of the two groups after one month and three years of surgery were significantly higher than those before the operation( P < 0. 05).However,there was no significant difference in the Harris scores between the two groups( P > 0. 05).In the HRA group,10 cases were excellent and 6 cases were good.The excellent and good rate was 72. 72%.In the THR group,8 cases were excellent and 7 cases were good.The excellent and good rate was75. 00%.The hip abduction,flexion,internal rotation,adduction and external rotation of the two groups were significantly better than those before operation( P < 0. 05),but no significant differences were found between the two groups( P > 0. 05).There were no significant difference in incidence of postoperative infection,joint dislocation,vascular nerve injury,and deep vein thrombosis between the two groups( P > 0. 05).Conclusion THR is suitable for patients with more severe bone defects.For some patients,HRA is used to effectively preserve bone mass for patients,which is helpful for postoperative exercise and quality of life.

关 键 词：全髋关节置换 全髋表面置换 髋臼骨折 

分 类 号：R683.42[医药卫生—骨科学]