微创全髋关节置换术治疗老年移位型股骨颈骨折50例

目的:探讨前外侧小切口入路微创全髋关节置换治疗老年股骨颈骨折的价值。方法:50例老年股骨颈骨折患者,其中Garden Ⅲ型29例,Garden Ⅳ型21例。均采用前外侧小切口行微创全髋关节置换。结果:手术切口平均长9cm(7~11cm)。手术时间60~100min,平均80min。随访6~28个月,无感染、脱位、神经损伤等严重并发症。术后早期X线片显示骨水泥型假体周围骨水泥分布均匀;髋关节功能按Harris评分标准评价:优35例、良13例、中1例。所有病例无下肢深静脉栓塞及术后感染发生,无明显双下肢不等长。结论:采用小切口人工髋关节置换切实可行,手术操作无明显困难,有创伤小、愈合快、失血少等优点。

Total Hip replacement with small incision for treating dislocated femoral neck fracture in the elderly

Objective:To discuss the feasibility and clinical effect of total hip replacement(THR)with anteroexternal small incision for treating femoral neck fracture in the elderly.Methods:Fifty femoral neck fractures with the age from seventy to eighty-five years old(31 males and 19 females)were treated with anteroexternal small incision THR,Garden III and Garden IV were 29 and 21 respectively.Results:The average incision length was 9cm(7～11cm)and the average operative time was 80 min ranging from 60 to 100 min.after6～28 months of followup and no severe complication such as infection,dislocation,nerve injective occurred.The early X-ray after operation showed that the bone cement were steady distribution around prosthesis.The Harris score of hip function:35 cases were excellent result,13 good,1 fair,There were no cases of dislocation、deep venous embolism、inequality of lower limb and infection.Conclusion:Total hip replacement with small incision has the advantages of mini injury,good postoperative recovery and less blood loss,which is a safe and feasible method for the treatment of femoral neck fracture in the elderly.