全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的疗效比较

目的比较全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的疗效。方法选取2016年1月~2017年1月在本院住院治疗的老年股骨颈骨折60例,年龄≥60周岁,其中30例采取全髋关节置换术,设立为A组,30例采取人工股骨头置换术,设立为B组,比较两组的手术时间、术中出血量、术后下床活动时间、Harris髋关节功能评分、术后并发症情况。结果 B组采用人工股骨头置换术的手术时间短于A组、术中出血少于A组,组间比较差异具有显著性(P0.05)。A组的术后下床活动时间(12.3±2.4)d、明显短于B组,组间比较差异具有显著性(P0.05)。A组采用全髋关节置换术的Harris髋关节功能评分优良率明显高于B组,组间比较差异具有显著性(P0.05)。两组术后均无一例发生切口感染、坠积性肺炎及褥疮等近期并发症。其中,A组发生远期并发症包括假体松动1例、异位骨化1例,B组发生远期并发症包括髋臼磨损1例、异位骨化1例,两组比较,差异无显著性(P0.05)。结论全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折均为有效的治疗方法之一,但人工股骨头置换术具有手术时间短、术中出血少的优点,而采取全髋关节置换术患者的髋关节功能改善效果更好。

Comparison between total hip arthroplasty and artificial femoral head replacement in the treatment of senile femoral neck fracture

Objective To compare the efficacy of total hip arthroplasty and artificial femoral head replacement in thetreatment of senile femoral neck fractures. Methods 60 cases of senile femoral neck fractures aged over 60 years who were hospitalized in our hospital from January 2016 to January 2017 were selected. 30 patients who underwent total hip arthroplasty were chosen as group A. And 30 patients who underwent artificial femoral head replacement surgery were set as the group B. The operation time, intraoperative blood loss, postoperative ambulation time, Harris hip function score, postoperative complications between the two groups were compared. Results The operation time of artificial femoral head replacement in group B was shorter than that of group A, and the intraoperative bleeding in group B was less than that of group A. There was significant difference between the two groups(P<0.05). The postoperative ambulation time(12.3±2.4) days in group A was significantly shorter than that in the group B, and the difference between thetwo groups was significant (P<0.05). The Harris hip function score of total hip arthroplasty recovery rate in group A was significantly higher than that of group B, and the difference was significant(P<0.05). No cases of recent complications such as incision infection, hypostatic pneumonia and bedsores in both groups. Among them, there were the long-term complications including 1 case of prosthesis loosening and 1 case of heterotopic ossification in group A. And there were long-term complications including 1 case of acetabular wear and 1 case of heterotopic ossification in group B. There was no significant difference between the two groups(P>0.05). Conclusion Total hip arthroplasty and artificial femoral head replacement for the treatment of elderly femoral neck fractures are effective treatment methods, but the artificial femoral head replacement surgery has the advantages of short operation time and less bleeding. And hip function improvement of patients with total hip replacement is better.