31例有并存症的老年股骨颈骨折髋关节置换术疗效分析

目的：评价实施有并存症的老年股骨颈骨折髋关节置换术的疗效等问题。方法：自1999年1月以来收治的65岁以上，GardenⅢ、Ⅳ型股骨颈骨折伴有并存症患者31例，分别采用全髋关节置换术（THR）和半髋关节置换术（PR）。结果：31例经20～81个月，平均37个月的时间随访。髋关节功能按照Harris评分标准，结果：全髋置换组：优12例，良6例，可2例，优良率为90．0％；半髋置换组：优5例，良4例，可2例，优良率为81．82％；本组优良率为87．10％，经X^2检验（x^2=0．73），两组优良率差异无显著性（P〉0．05）。结论：根据术前评估并将其分级认为：选择全髋或半髋关节置换都是治疗伴有并存症的老年股骨颈骨折的较好的方法，Ⅰ级和部分Ⅱ级选择全髋置换术，Ⅲ级以半髋关节置换术为佳，达到病人安全度过手术期，恢复功能活动，提高患者生活质量。

Effect of Hip Replacement for Femoral Neck Fracture in Elderly Patients with Complications

Objective： To evaluate the clinical efficacy of hip replacement for femoral neck fracture in elderly patients with complications. Methods：From January 1999, 31 patients of femoral neck fracture （Garden Ⅲ -- Ⅳ） above 65 years with complications were enrolled. They either received total hip replacement （THR） or partial hip replacement （PR） operations since 1999. Results.. All patients were followed up for 20-81 months with an average of 37 months. According to Harris＇ hip rating scale system, the results were excellent in 12 cases, good in 6 and fair in 2 in THR group and the excellent and good rate was 90.0%. While in PR group, excellent results were obtained in 5 cases, good in 4 and fair in 2 and the excellent and good rate was 81. 82%. The total excellent and good rate was 87.10% and there was no significant difference between the two groups （P〉0.05）. Conclusion： It is a satisfactory method to evaluate the function and classification of patients before operation. THR is preferably better for Garden Ⅰ type and part of Garden Ⅱ type while PR for Garden Ⅲ and Ⅳ type, which can avoid the risk during the operative time, restore the function and improve the life quality in the aged patients.