股骨近端骨折内固定失败后全髋关节置换术:50例囊内骨折和囊外骨折分析  

Total hip arthroplasty after failed internal fixation for proximal femoral fractures:Analysis of 50 cases of intra and extracapsular fractures

作　　者：曹耀威 李哲[1] 骆晓飞 孙京涛 蔡松涛 魏瑄 王金良 CAO Yaowei;LI Zhe;LUO Xiaofei;SUN Jingtao;CAI Songtao;WEI Xuan;WANG Jinliang(Zhengzhou Orthopaedics Hospital of Henan University,Zhengzhou 450015,Henan,China)

机构地区：[1]河南大学附属郑州市骨科医院,河南郑州450015

出　　处：《武汉大学学报（医学版）》2023年第6期719-723,共5页Medical Journal of Wuhan University

摘　　要：目的:回顾性分析股骨近端骨折内固定失败后全髋关节置换的疗效,比较股骨近端囊内骨折和囊外骨折内固定失败后髋关节置换两种类型的技术、临床结果、并发症。方法:将2013年6月—2018年6月50例股骨近端骨折内固定失败后全髋关节置换术患者纳入研究,全髋关节置换术均Ⅰ期完成。术后定期随访。结果:囊内骨折组平均手术时间(72.4±14.3)min,平均出血量(322.6±135.2)mL,均少于囊外骨折组平均手术时间(81.3±17.6)min和平均出血量(543.4±108.3)mL,两组有显著性差异。平均随访38个月,囊内骨折组Harris评分(85.5±16.2),高于囊外骨折组评分(73.4±13.1;P=0.01)。结论:股骨近端骨折内固定失败后全髋关节置换术比常规髋关节置换术有更多并发症,与囊内骨折相比,囊外骨折组手术时间更长,出血、并发症更多,假体生存率相对更低。Objective:To retrospectively analyze the outcome of total hip arthroplasty for failed internal fixation of proximal femoral fracture,and to compare the techniques,clinical results,and complications of internal fixation of proximal femoral fracture between intra-and extra-capsule types.Methods:Fifty cases were retrospectively studied from June 2013 to June 2018.Internal fixation removal and total hip arthroplasty were completed in one stage.Reguler follow-up were completed and every year afterwards.Results:In intra-capsule fracture group,the operation time was(72.4±14.3)min and mean blood loss was(322.6±135.2)mL,which was significantly less than(81.3±17.6)min and(543.4±108.3)mL,respectively,in extra-capsule fracture group.After a mean follow-up time of 38 months,the intra-capsule group had a Harris score of 85.5±16.2,which was higher than that in extra-capsule group(vs 73.4±13.1,P=0.01).Conclusion:Total hip arthroplasty for failed proximal femoral fracture had more complications than regular total hip arthroplasty.Compared with that for intra-capsule fractures,the surgical ourcome of internal fixation for extra-capsule fractures was worse in longer operation time,more blood loss,more complications,and lower prosthesis survival rate.

关 键 词：股骨近端骨折 内固定失败 髋关节置换 

分 类 号：R684[医药卫生—骨科学]