全髋与半髋关节置换术治疗老年股骨颈骨折的效果比较  

Comparison on the effects of total hip replacement versus hemiarthroplasty in the treatment of elderly femoral neck fractures

作　　者：侯江业 李耀章 杨振邦[1] 张宁 Hou Jiangye;Li Yaozhang;Yang Zhenbang;Zhang Ning(Department of Orthopedics,Yulin First Hospital,Yulin 719000,China)

机构地区：[1]榆林市第一医院骨科,榆林719000

出　　处：《中国实用医刊》2024年第17期29-32,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较全髋与半髋关节置换术治疗老年股骨颈骨折的临床疗效。方法回顾性抽取2022年3月至2023年6月榆林市第一医院收治的72例老年股骨颈骨折患者为研究对象。将入选者按电脑盲选法分为半髋组与全髋组,每组36例。半髋组采用半髋关节置换术,全髋组采用全髋关节置换术。比较两组手术相关指标、关节功能恢复情况(Harris评分、关节活动度)及并发症发生率。结果全髋组手术时间、住院时间少于半髋组,切口长度长于半髋组,术后引流量多于半髋组,下地负重时间短于半髋组(P<0.05)。术前,两组Harris评分比较差异未见统计学意义(P>0.05);术后3个月,全髋组各项评分均高于半髋组(P均<0.05)。术前,两组患者髋关节活动度比较差异未见统计学意义(P>0.05);术后第3、6个月,全髋组各个方向的活动度均大于半髋组(P均<0.05)。全髋组并发症发生率(8.33%,3/36)低于半髋组(44.44%,16/36),P<0.05。结论对于老年股骨颈骨折患者的治疗,全髋置换术虽然创伤较大,但髋关节功能恢复更佳,并发症发生率更少,手术安全性高,远期疗效显著;半髋关节置换术虽创伤小,但关节恢复效果不如前者。Objective To compare the clinical efficacy of total hip replacement and hemiarthroplasty in the treatment of elderly femoral neck fractures.Methods A total of 72 elderly patients with femoral neck fractures admitted to Yulin First Hospital from March 2022 to June 2023 were selected as the study subjects retrospectively.And they were divided into a semi-hip group and a total hip group using computer blind selection method,with 36 cases in each group.The semi-hip group was treated by hemiarthroplasty,while the total hip group was treated by total hip replacement.The total efficacy and surgical related indicators,joint function recovery assessed by Harris score and joint range of motion,incidence of complications were compared between the two groups.Results The total hip group had less surgical time,less hospital stay,longer incision length and more postoperative drainage compared with the semi-hip group(P<0.05).However,the total hip group had shorter weight-bearing time on the ground than the semi-hip group(P<0.05).There was no difference in Harris scores between the two groups before surgery(P>0.05);3 month after surgery each item-score of Harris score in the total hip group was higher than that in the semi-hip group,correspondingly(all P<0.05).There was no significant difference in hip joint range of motion between the two groups before surgery(P>0.05).The 3-and 6-month postoperative range of motion in all directions in the total hip group were greater than those in the semi-hip group(all P<0.05).The incidence of complications in the total hip group(8.33%,3/36)was lower than that in the semi-hip group(44.44%,16/36),P<0.05.Conclusions For elderly patients with femoral neck fractures,total hip replacement,although more traumatic,has better hip joint function recovery,lower incidence of complications,high surgical safety,and significant long-term efficacy.Although hemiarthroplasty has less trauma,its joint recovery effect is not as good as the former.

关 键 词：髋关节置换术 半髋关节置换术 老年 股骨颈骨折 

分 类 号：R687.4[医药卫生—骨科学]