人工髋关节置换在治疗老年股骨颈骨折的应用

目的探讨人工股骨头或全髋关节置换术治疗老年股骨颈骨折的疗效。方法 2000年8月至2010年9月对46例（50髋）老年股骨颈骨折患者进行了人工股骨头或全髋关节置换。其中双侧4例,单侧42例。年龄64~93岁,平均71.6岁。结果所有患者手术顺利进行,术后伤口均一期愈合。术后5个月患者均能下地行走,生活自理。平均Harris评分由术前的（45±11）分恢复到术后1年的（92±7）分,术后与术前Harris评分比较t=21.1674,P〈0.05。术后并发症脱位2例,精神症状2例。本组患者无肺栓塞、深静脉血栓形成、感染等并发症发生。随访6~48个月,平均14.6个月,X线片检查示假体位置良好。结论人工股骨头或全髋关节置换术是治疗老年股骨颈骨折的一种有效方法。

Treatment of the fracture of femur neck with total hip arthroplasty in the elderly

Objective To investigate the clinical effect of treatment of the fracture of femur neck with arthroplasty in the elderly.Methods Forty-six cases with the fracture of femur neck had been treated with arthroplasty between Aug.2000 and Nov.2010.Twenty-five cases in the forty six patients with the fracture of femur neck had been treated with total hip replacement.There were 4 patients out of the 46 patients in bilateral hip and 42 patients out of the 46 patients in unilateral hip.The age of the patients at surgery ranged from 64-93 years（mean age was 71.6 years）.Results The operations had been performed successfully,and the incision had healed well.All patients could walk independently without aiding and take care of themselves in 5 months postoperation.The preoperation functional scores of hips averaged（45±11）,and postoperation functional scores（92±7） after one year postoperatively.The difference had statistical significance between postoperation functional scores of hips and preoperation functional scores（t=21.1674,P0.05）.The intraoperative and postoperative complications had happened in 4 cases.The dislocation of hips had happened in 2 cases,and mental symptoms in 2 cases respectively.No other complications had happened in the series.The mean followed up period was 14.6 months,ranging from 6 to 48 months.The position of the components were radiographic satisfactory.Conclusion THA is an effective way in treating the fracture of femur neck in the elderly.