后外侧入路与直接前侧入路全髋关节置换术治疗股骨颈骨折的效果比较  

Comparison of the effect of total hip arthroplasty through posterolateral approach and direct anterior approach in the treatment of femoral neck fracture

作　　者：周三国[1] 吴若丹[1] 杨凯 Zhou Sanguo;Wu Ruodan;Yang Kai(Department of Joint Surgery,Jiaozuo People’s Hospital,Jiaozuo 454002,China)

机构地区：[1]焦作市人民医院关节外科,焦作454002

出　　处：《中国实用医刊》2025年第4期36-39,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较后外侧入路与直接前侧入路全髋关节置换术治疗股骨颈骨折的临床效果。方法队列研究。抽取2020年1月至2022年12月焦作市人民医院收治的120例股骨颈骨折患者作为研究对象,按随机数字表法分为A组和B组,每组60例。A组采用后外侧入路全髋关节置换术治疗,B组采用直接前侧入路全髋关节置换术治疗。比较两组手术相关指标(手术时间、术中出血量、切口长度、术后引流量)、髋臼假体(前倾角、外展角)角度、髋关节功能(Harris髋关节评分)及平衡功能[Berg平衡量表(BBS)评分],并统计两组术后并发症发生情况。结果B组手术时间长于A组,但术中出血量、切口长度及术后引流量均低于A组(P均<0.05)。术后3个月,两组髋臼假体前倾角均较术后1 d时升高,外展角均较术后1 d时降低(P<0.05),但两组术后1 d、3个月的髋臼假体前倾角、外展角比较差异未见统计学意义(P>0.05)。术后3个月,两组Harris髋关节评分及BBS评分均较术前升高,且B组高于A组(P<0.05)。B组术后并发症发生率(3.33%,2/60)低于A组(15.00%,9/60),P<0.05。结论与后外侧入路全髋关节置换术比较,直接前侧入路全髋关节置换术虽手术时间较长,但可减少术中出血量、缩短切口长度,更有利于促进术后髋关节功能及平衡功能的恢复,且并发症更少。ObjectiveTo compare the clinical effects of total hip arthroplasty through posterolateral approach and direct anterior approach in the treatment of femoral neck fracture.MethodsA total of 120 patients with femoral neck fracture admitted to Jiaozuo People’s Hospital from January 2020 to December 2022 were selected as the research objects for the cohort study,and they were divided into the group A and the group B according to the random number table method,with 60 cases in each group.The group A was treated by total hip arthroplasty via posterolateral approach,and the group B was treated by total hip arthroplasty via direct anterior approach.The operation-related indicators,including operation duration,intraoperative blood loss,incision length and postoperative drainage,acetabular prosthesis angles,including anteversion angle and abduction angle,hip function assessed by Harris hip score,and balance function assessed by Berg balance scale(BBS)score were compared between the two groups.The postoperative complications of the two groups were counted.ResultsThe operation duration of the group B was longer than that of the group A,but the intraoperative blood loss,incision length and postoperative drainage volume were lower than those of the group A(all P<0.05).At 3 months after operation,the anteversion angle of acetabular prosthesis in both groups were higher than those at 1 day after operation,and the abduction angles were lower than those at 1 day after operation(P<0.05).At 1 day and 3 months after operation,there was no significant difference in the anteversion angles and abduction angle of acetabular prosthesis between the two groups(P>0.05).At 3 months after operation,the Harris hip scores and BBS scores of the two groups were higher than those before operation,and the group B had higher Harris hip score and BBS score than the group A(P<0.05).The incidence of postoperative complications in the group B(3.33%,2/60)was lower than that in the group A(15.00%,9/60),P<0.05.ConclusionsCompared with the total hip arthrop

关 键 词：股骨颈骨折 后外侧入路 直接前侧入路 全髋关节置换术 

分 类 号：R687.3[医药卫生—骨科学]