两种入路全髋关节置换术治疗股骨颈骨折的疗效比较  

The comparison effect of total hip arthroplasty via two kinds of approaches for femoral neck fracture

作　　者：孙伟[1] SUN Wei(Dept of Orthopaedics,the Seventh People′s Hosptial of Chengdu,Chengdu,Sichuan 610021,China)

机构地区：[1]成都市第七人民医院骨科,四川成都610021

出　　处：《临床骨科杂志》2024年第1期35-39,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较Hardinge入路与SuperPATH入路行全髋关节置换术(THA)治疗股骨颈骨折的疗效。方法将100例股骨颈骨折患者根据随机数字表法分为SuperPATH组(采用SuperPATH入路THA治疗)和Hardinge组(采用Hardinge入路THA治疗),每组50例。记录两组手术情况、髋臼外展角及其安全区占比、前倾角及其安全区占比、偏心距及其恢复率、双下肢长度差以及并发症发生情况。采用Harris评分评价髋关节功能。结果患者均获得随访,时间12~16个月。切口长度、术中出血量、术后不负重下地时间、住院时间SuperPATH组均短(少)于Hardinge组(P<0.05)。手术时间SuperPATH组长于Hardinge组(P<0.05)。术后6个月髋臼外展角及其安全区占比、髋臼前倾角及其安全区占比、偏心距及其恢复率、双下肢长度差两组比较差异均无统计学意义(P>0.05)。Harris评分优良率术后6个月SuperPATH组高于Hardinge组(P<0.05),术后12个月两组比较差异无统计意义(P>0.05)。术后并发症发生率SuperPATH组低于Hardinge组(P<0.05)。结论与Hardinge入路比较,SuperPATH入路THA治疗股骨颈骨折虽存在一定的学习曲线,但也可准确置入假体,且具有创伤小、并发症少、康复快、短期疗效好等优点。Objective To compare the efficacy of total hip arthroplasty(THA)for treatment of femoral neck fracture via Hardinge approach and SuperPATH approach.Methods The 100 patients with femoral neck fractures were divided into SuperPATH group(treated with SuperPATH approach THA)and Hardinge group(treated with Hardinge approach THA),according to random number table method,with 50 cases in each group.Operation conditions,acetabular abduction angle and its safe zone ratio,anterior inclination angle and its safe zone ratio,offset and its recovery rate,length difference of both lower limbs and the incidence of complications were recorded in the two groups.Hip function was assessed by Harris score.Results All patients were followed up was 12~16 months.Incision length,intraoperative blood loss,start walking time without weight-bearing and length of hospital stay in SuperPATH group were all shorter(less)than those in Hardinge group(P<0.05).The operation time of SuperPATH group was longer than that of Hardinge group(P<0.05).At 6 months after operation,there were no statistical differences in acetabular abduction angle and its safe zone ratio,acetabular anterior inclination angle and its safe zone ratio,offset and its recovery rate,and lower limb length difference between the two groups(P>0.05).The excellent-good rate of Harris score:at 6 months after operation,SuperPATH group was higher than Hardinge group(P>0.05),and two groups had no difference at 12 months postoperation(P<0.05).Conclusions Compared with Hardinge approach,although SuperPATH approach has a certain learning curve for the treatment of femoral neck fracture,it can accurately insert prosthesis,and has the advantages of less trauma,fewer complications,faster recovery,and better short-term efficacy.

关 键 词：SuperPATH入路 Hardinge入路 全髋关节置换术 股骨颈骨折 

分 类 号：R687.4[医药卫生—骨科学] R683.42[医药卫生—外科学]