直接前入路人工股骨头置换术对高龄股骨颈骨折患者术后康复及髋关节功能的影响

目的探讨直接前入路(DAA)人工股骨头置换术(HHA)对高龄股骨颈骨折患者术后康复及髋关节功能的影响。方法选取我院2016年5月至2019年5月收治的90例高龄股骨颈骨折患者,根据手术方案将其分为对照组(45例,微创后外侧入路HHA)和观察组(45例,DAA HHA)。比较两组的手术相关指标、疼痛程度、影像学信息、单腿站立试验阴性率、髋关节功能及并发症发生情况。结果观察组手术时间长于对照组,术中出血量少于对照组,术后可持续坐位1 h所需时间及住院时间短于对照组(P<0.05)。两组术前、术后1、3 d、1个月的VAS评分比较,差异无统计学意义(P>0.05)。两组均无明显假体内外翻,观察组术后下肢长度差值明显短于对照组(P<0.05)。术后1个月,观察组患侧单腿站立试验阴性率高于对照组(P<0.05)。术后1个月,观察组的Harris评分高于对照组(P<0.05)。观察组肺炎发生率低于对照组(P<0.05)。结论 DAA HHA治疗高龄股骨颈骨折患者可促进其术后康复,改善髋关节功能。

Effects of direct anterior approach hip hemiarthroplasty on postoperative rehabilitation and hip joint function of elderly patients with femoral neck fracture

Objective To explore the effects of direct anterior approach(DAA) hip hemiarthroplasty(HHA) on postoperative rehabilitation and hip joint function of elderly patients with femoral neck fracture. Methods Ninety elderly patients with femoral neck fracture admitted in our hospital from May 2016 to May 2019 were selected and divided into control group(45 cases, minimally invasive posterolateral approach HHA) and observation group(45 cases, DAA HHA)according to the surgical plan. The operation-related indexes, pain level, imaging information, the negative rate of singleleg standing test, hip joint function and complications were compared between the two groups. Results The operation time in the observation group was longer than that in the control group, the amount of bleeding during the operation was less than that in the control group, and the required time of continuous sitting position for 1 h after surgery and the hospitalization time were shorter than those in the control group(P<0.05). There were no significant differences in VAS scores between the two groups before and 1 day, 3 day and 1 month after operation(P>0.05). There were no significant prothesis eversion in both groups, and the difference of leg length after operation in the observation group was significantly shorter than that in the control group(P <0.05). One month after operation, the negative rate of single leg standing test in the observation group was higher than that in the control group(P<0.05). One month after operation, the Harris score in the observation group was higher than that in the control group(P<0.05). The incidence of pneumonia in the observation group was lower than that in the control group(P <0.05). Conclusion DAA HHA can promote postoperative rehabilitation and improve hip joint function in the treatment of elderly patients with femoral neck fracture.