闭合复位空心加压螺钉内固定术与人工双极股骨头置换术治疗老年移位性股骨颈骨折的效果比较  

Comparison on efficacy of closed reduction and hollow compression screw internal fixation versus artificial bipolar femoral head replacement in the treatment of displaced femoral neck fracture in the elderly

作　　者：任耀 张凯 张帅良 易维 Ren Yao;Zhang Kai;Zhang Shuailiang;Yi Wei(Department of OrthopaedicsⅡ,the First People’s Hospital of Zhumadian,Zhumadian 463000,China)

机构地区：[1]驻马店市第一人民医院骨二科,驻马店463000

出　　处：《中国实用医刊》2022年第17期38-42,共5页Chinese Journal of Practical Medicine

摘　　要：目的比较闭合复位空心加压螺钉内固定术与人工双极股骨头置换术治疗老年移位性股骨颈骨折的临床效果。方法抽取2017年4月至2020年2月驻马店市第一人民医院收治的94例老年移位性股骨颈骨折患者为研究对象,按随机数字表法分为A组与B组,每组47例。A组采用闭合复位空心加压螺钉内固定术,B组采用人工双极股骨头置换术。比较两组手术相关指标、髋关节功能及不良事件发生情况。结果B组手术时间长于A组,术中出血量大于A组,差异有统计学意义(P<0.05),但术后住院时间与卧床时间短于A组(P<0.05)。术后6、12个月,B组的髋关节功能优良率[90.5%(38/42)、87.8%(36/41)]高于A组[68.3%(28/41)、69.2%(27/39)],P<0.05。B组术后关节功能、疼痛、关节畸形评分与总分均高于A组(P均<0.05)。B组不良事件发生率(8.5%,4/47)低于A组(23.4%,11/47),P<0.05。结论人工双极股骨头置换术治疗老年移位性股骨颈骨折效果较好,可达到更好的关节功能恢复效果,减少二次手术。Objective To compare the clinical effect of closed reduction and hollow compression screw internal fixation and artificial bipolar femoral head replacement(ABFHR)in the treatment of displaced femoral neck fracture in the elderly.Methods A total of 94 elderly patients with displaced femoral neck fractures admitted to the First People’s Hospital of Zhumadian from April 2017 to February 2020 were divided into group A and group B by random number table method,with 47 patients in each group.Group A accepted closed reduction and hollow compression screw internal fixation,while group B accepted ABFHR.The operation related indexes,hip joint function and adverse events were compared between the two groups.Results The operation time in the group B was longer than that in the group A,and the intraoperative blood loss was greater than that in the group A(P<0.05),but the postoperative hospitalization time and bed time were shorter than those in the group A(P<0.05).The 6-and 12-month postoperative excellent and good rate of hip joint function in the group B(90.5%,38/42;87.8%,36/41)were higher than those in the group A(68.3%,28/41;69.2%,27/39),P<0.05.The scores and total scores of joint function,pain and joint deformity in the group B were higher than those in the group A(all P<0.05).The incidence of adverse events in the group B(8.5%,4/47)was lower than that in the group A(23.4%,11/47),P<0.05.Conclusions ABFHR is effective in treating elder patients with displaced femoral neck fractures,which can achieve better joint function recovery,and reduce secondary operations.

关 键 词：股骨颈骨折 人工双极股骨头置换术 空心加压螺钉内固定术 疗效 

分 类 号：R687.3[医药卫生—骨科学]