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老年髋臼骨折采用不同固定术联合全髋关节置换效果与预后研究
引用本文:王勇.老年髋臼骨折采用不同固定术联合全髋关节置换效果与预后研究[J].亚太传统医药,2014(21):65-67.
作者姓名:王勇
作者单位:武汉科技大学附属天佑医院,湖北武汉430064
摘    要:目的:比较切开复位内固定术(open reduction and internal fixation,ORIF)联合全髋关节置换(total hip arthroplasty,THA)与采用经皮固定联合全髋关节置换两种疗法对老年髋臼骨折的临床疗效。方法:选择65名年龄在60岁以上的髋臼骨折患者,其中30例行切开复位内固定术联合全髋关节置换术,35例行经皮固定联合全髋关节置换术。术中记录失血量、手术时间;术后常规给予抗凝药物预防深静脉血栓形成,按康复计划进行恢复性功能锻炼,定期随访患者并发症情况,并定时行髋关节功能Harris评分评估。结果:经皮固定联合全髋关节置换组失血量少,但手术时间较切开复位内固定组联合全髋关节置换组略长;两种手术方式并发症类型有所不同,经皮固定联合全髋关节置换组并发症率稍高;随访时间1~6年,平均随访3年,最后随访时,切开复位内固定组Harris评分平均分为79分,优良率为64.0%;经皮固定组Harris评分平均分为83分,优良率为72.0%。结论:经皮固定联合全髋关节置换组髋关节功能恢复较好,术中失血少,但手术时间及并发症率稍高于切开复位内固定联合全髋关节置换组。在临床治疗选择时可根据患者情况选择手术方式。

关 键 词:髋臼骨折  髋关节置换术  切开复位内固定术  经皮固定术

Study on the Effect and Prognosis of Different Fixation Combined with Total Hip Arthroplasty using Old Acetabular Fracture
Wang Yong.Study on the Effect and Prognosis of Different Fixation Combined with Total Hip Arthroplasty using Old Acetabular Fracture[J].Asia-Pacific Traditional Medicine,2014(21):65-67.
Authors:Wang Yong
Institution:Wang Yong (Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Hubei 430064,China)
Abstract:Objective:To compare the clinical results of open reduction and internal fixation combined total hip arthroplasty with intradermic fixation of fracture combined total hip arthroplasty in the treatment of acetabular fractures in the elderly.Methods:65 patients over 60 years,with acetabular fratures were treated.Among them 30 underwent open reduction and internal fixation of the fracture combined total hip arthroplasty while 35 had intradermic fixation of fracture combined total hip arthroplasty.Taking down the operation records of bleeding volume and operation time.After surgery give anticoagulant drugs to prevent venar profundae thrombosis,obey the rehabilitation plans,regular follow-up in patients and make Harris score assessment on schedule.Results:The group of internal fixation of the fracture combined total hip arthroplasty has less bleeding volume,but longer operation time and higher complication rates.All cases had been followed up for 1~6 years with a mean of 3 years.The latest follow-up revealed a mean Harris score of 79 in the group of ROIF,while the Harris score in the intradermic fixation of fracture group was averaged 83.Conclusion:The group of intradermic fixation of fracture combined total hip arthroplasty has a better function recovery and less bleeding volume,but with longer operation time and higher complicaiton rate.Operation mode can be selected according to the conditions of patients.
Keywords:Acetabular Fractures  Total Hip Arthroplasty  Open Reduction and Internal Fixation  Intradermic Fixation of Fracture
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