髋关节置换术与内固定术治疗老年股骨颈骨折的临床对比研究

目的：探讨髋关节置换术与骨折内固定术治疗老年股骨颈骨折的临床疗效。方法：回顾性分析2010年1月-2012年12月140例在本院行股骨颈骨折手术的老年患者的临床资料，其中全髋关节置换术38例（观察组A）、人工股骨头置换术49例（观察组B），骨折内固定53例（对照组）。比较三组的手术时间、术中出血量、住院费用和术后下床锻炼时间，随访并采用髋关节功能Harris评分评价疗效。结果：两观察组术后下床锻炼时间明显早于对照组，比较差异均有统计学意义（P〈0.05）；两观察组的Harris评分明显高于对照组，比较差异均有统计学意义（P〈0.05）；两观察组Harris评分优良率明显高于对照组，比较差异均有统计学意义（P〈0.05）；但是对照组的手术时间术中出血量和住院费用明显低于两观察组，比较差异均有统计学意义（P〈0.05）。结论：髋关节置换术和骨折内固定术均是治疗老年股骨颈骨折的有效手术方式，应根据患者状况、骨折类型制定个体化治疗方案。

The Clinical Research of Senile Femoral Neck Fracture Treated by the Hip Arthroplasty and Fracture Fixation

Objective：To evaluate the curative effect analysis of senile femoral neck fracture treated by the total hip arthroplasty and fracture fixation. Method：Retrospective analysis the clinical data of 170 elderly patients received femoral neck fracture surgery from January 2010 to December 2012,total hip replacement 38 cases（observation group A）,artificial femoral head replacement 49 cases（observation group B）,fracture internal fixation 53 cases（control group）. The operation time,intraoperative blood loss,hospitalization expenses and postoperative bed time of the three groups were compared, follow-up and use the Harris hip function score evaluated the curative effect. Result：The postoperative bed time of two observation group were shorter than that of the control group,and the differences were all statistically significant（P＆lt;0.05）. The Harris score of two observation group were obviously higher than that of control group,and the difference were all statistically significant（P＆lt;0.05）. Harris score good rate of the two observation group were significantly higher than that of the control group,and the differences were all statistically significant（P＆lt;0.05）.But the operation time,intraoperative blood loss and hospitalization costs of the control group were significantly lower than those of the two observation group,and the differences were all statistically significant（P＆lt;0.05）. Conclusion：The hip arthroplasty and fracture fixation are effective surgical procedure for treatment of senile femoral neck fracture,which should make individualized treatment plan according to patients condition and the types of fracture.