髋关节置换与骨折内固定治疗老年股骨颈骨折比较  

Comparison of hip Replacement and Fracture Internal Fixation in the Treatment of Femoral Neck Fracture in the Elderly

作　　者：冯锁立 雷广鹏 王博 FENG Suoli;LEI Guangpeng;WANG Bo(Department of Orthopedics,Jilin Oilfield General Hospital,Songyuan Jilin 138000,China)

机构地区：[1]松原吉林油田医院骨科,吉林松原138000

出　　处：《中国卫生标准管理》2022年第16期58-62,共5页China Health Standard Management

摘　　要：目的 探究髋关节置换与骨折内固定治疗老年股骨颈骨折的临床疗效。方法 选取在本院行手术治疗的70例老年股骨颈骨折患者(2013年2月—2022年2月),随机分为关节置换组和内固定组,每组35例。内固定组行骨折内固定治疗,关节置换组行髋关节置换术治疗,比较两组患者术后髋关节功能,并比较两组手术康复情况和并发症发生率。结果 关节置换组髋关节功能优良率(91.43%,32/35)明显高于内固定组(74.29%,26/35)(P<0.05)。关节置换组手术用时、术中出血量显著高于内固定组(P<0.05);关节置换组术后3个月Harris量表各项评分和总分均显著高于内固定组(P<0.05)。关节置换组下床活动时间[(16.25±3.26)d]、术后住院时间[(17.63±2.58)d]、骨折愈合时间[(36.01±5.98)d]均显著低于内固定组[(24.13±5.11)、(23.36±4.13)、(48.75±4.02)d](P<0.05)。关节置换组术后并发症发生率(8.57%,3/35)显著低于内固定组(28.57%,10/35)(P<0.05)。结论 髋关节置换术后髋关节功能改善效果优于骨折内固定术,可有效提升髋关节活动度,减轻疼痛,同时可缩短患者术后康复时间,且进一步降低了并发症风险,治疗老年股骨颈骨折安全可靠。Objective To investigate the clinical efficacy of hip replacement and internal fixation in the treatment of femoral neck fracture in the elderly.Methods A total of 70 elderly patients with femoral neck fracture who underwent surgical treatment in our hospital from February 2013 to February 2022 were selected and randomly divided into joint replacement group and internal fixation group,3 5 cases in each group.The internal fixation group was treated with fracture internal fixation,and the joint replacement group was treated with hip replacement.The postoperative hip function was compared between the two groups,and the postoperative rehabilitation and the incidence of complications were compared between the two groups.Results The excellent and good rate of hip joint function in the joint replacement group(91.43%,3 2/3 5) was significantly higher than that in the internal fixation group(74.29%,26/35)(P<0.05).The operation time and intraoperative blood loss in the joint replacement group were significantly higher than those in the internal fixation group(P<0.05).The scores and total scores of Harris scale in the joint replacement group were significantly higher than those in the internal fixation group at 3 months after operation(P<0.05).The ambulation time of joint replacement group[(16.25±3.26)d],postoperative hospital stay [(17.63±2.5 8)d],fracture healing time [(36.01±5.98)d] were significantly lower than those of internal fixation group [(24.13±5.11),(23.36±4.13),(48.75±4.02)d](P<0.05).The incidence of postoperative complications in the joint replacement group(8.57%,3/35) was significantly lower than that in the internal fixation group(28.57%,10/35)(P<0.05).Conclusion The improvement effect of hip joint function after hip replacement is better than that of internal fixation,which can effectively improve the range of motion of the hip joint,reduce pain,shorten the postoperative recovery time of patients,and further reduce the risk of complications.The treatment of elderly femoral neck fractures is safe and r

关 键 词：髋关节置换术 骨折内固定术 老年 股骨颈骨折 临床疗效 并发症 

分 类 号：R687[医药卫生—骨科学]