人工髋关节置换在高龄股骨颈骨折治疗中的应用

目的 探索人工髋关节置换术治疗高龄老年股骨颈骨折可行性.方法 回顾性分析自2000年至2006年选取人工髋关节置换治疗股骨颈骨折30例,选取采用内固定治疗股骨颈骨折30例.随访3个月～72个月.结果 关节置换组全髋置换15例全部愈合,术后均无切口感染,无并发症,harris评分90%;人工股骨头置换15例,14例愈合,1例髋关节脱位发生,harris评分80%.对照组中:股骨颈空心钉15例,11例愈合,3例骨不连接,1例股骨头缺血坏死,harris评分65%;股骨颈动力髋15例,13例愈合良好,2例畸形愈合,关节功能受限;harris评分70%.结论 人工髋关节置换在治疗高龄股骨颈骨折中是一种安全有效的髋关节功能重建的治疗方法.具有住院时间短、恢复快、治愈率高、并发症少等特点,有助提高患者治疗成功率和生存质量.

Application of artificial hip joint replacement in aged patient with femoral neck fracture

Objective To explore the feasibility of artificial hip joint replacement in aged patient with femoral neck fracture. Methods From January 1st, 2000 to December 31st, 2006, 30 cases of femoral neck fracture treated with artificial hip joint replacement and 30 cases of femoral neck fracture treated with internal fixation were retrospectively analyzed. All the patients were fellow-up for three to seventy-two months. Results All the 15 cases were cured in total artificial hip replacement group. There were no wound infections and complications after operation, with Harris hip score of 90%. Fourteen of fifteen cases were cured, but one hip joint dislocation occurred in artificial femoral head replacement group, with Harris hip score of 80%. Eleven of fifteen cases cured but one ischemia necrosis of the femoral head and three non-union occurred in open hole nail group, with Harris hip score of 65%. Thirteen of fifteen cases were cured but two healed with abnormality and limited hip joint function in dynamic hip screw group, with Harris hip score of 70%. Conclusions Artificial hip joint replacement is a safe and effective treatment method for hip joint functional reconstruction in aged patient with femoral neck fracture. The patients may have high living value with the advantage of short hospital stay, fast recovery, high cure rate and less complication.