全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的疗效分析

目的分析全髋关节置换术和半髋关节置换术在老年股骨颈骨折患者治疗中的疗效差异。方法选取2014年10月至2019年10月于本院采用人工髋关节置换术治疗的94例老年股骨颈骨折患者作为研究对象,根据手术方式不同分为两组,各47例。观察组采用全髋关节置换术,对照组采用半髋关节置换术。比较两组临床疗效、围手术期指标、住院时间、并发症发生率、手术前后疼痛(VAS)评分、髋关节功能(Harris)评分和术后1年的髋臼角度。结果两组住院时间、术前VAS评分和Harris评分比较差异无统计学意义;观察组治疗总有效率、术中出血量、术后3、6个月的Harris评分均高于对照组(P<0.05);观察组手术时间长于对照组,髋关节功能恢复时间短于对照组(P<0.05);观察组并发症发生率和术后VAS评分均低于对照组(P<0.05);观察组术后1年时的假体髋臼前倾角和假体髋臼外展角度均优于对照组(P<0.05)。结论在老年股骨颈骨折患者治疗中,全髋关节置换术的治疗效果更好,虽然该术式具有手术时间长和术中出血量多的缺陷,但不会延长患者住院时间,且患者术后疼痛评分及并发症发生率均较低,且还能缩短患者的髋关节功能恢复时间,有助于提升患者髋关节功能恢复效果,对改善患者预后具有重要意义,临床应用价值较高。

Total hip arthroplasty and half hip arthroplasty in the treatment of femoral neck fracture in the elderly

Objective To compare and analyze the efficacy of total hip arthroplasty and half hip arthroplasty in the treatment of elderly patients with femoral neck fracture. Methods 94 elderly patients with femoral neck fracture who underwent total hip arthroplasty treatment in our hospital from October 2014 to October 2019 were selected as the research subjects. They were divided into two groups according to different surgical methods, with 47 cases in each group. Total hip arthroplasty was used in the observation group and half hip arthroplasty was used in the control group.The clinical efficacy, perioperative indexes, hospital stay, incidence of complications, preoperative and postoperative pain(VAS) score, hip function(Harris) score and acetabular angle 1 year after operation were compared between the two groups. Results There was no significant difference in hospital stay, preoperative VAS score and Harris score between the two groups;the total effective rate, intraoperative bleeding and Harris score at 3 and 6 months after operation in the observation group were higher than those in the control group(P<0.05);the operation time in the observation group was longer than that in the control group, and the recovery time of hip function was shorter than that in the control group(P<0.05);the incidence of complications and postoperative VAS score in the observation group were lower than those in the control group(P<0.05);the acetabular anteversion angle and acetabular abduction angle of the observation group at 1 year after operation were better than those of the control group(P<0.05). Conclusion In the treatment of elderly patients with femoral neck fracture, total hip arthroplasty is more effective, although it has the defects of long operation time and large amount of intraoperative bleeding, however, the hospital stay will not be prolonged, and the postoperative pain score and complication rate are low, it can also shorten the recovery time of hip function and help to improve the recovery effect of hip function, and it is of great significance to improve the prognosis of patients and has high clinical value.