人工股骨头置换与全髋关节置换术治疗股骨颈骨折

目的了解、评价人工股骨头置换与全髋关节置换术治疗股骨颈骨折的价值和选择。方法从１９９０年１月～１９９６年１２月住院治疗的股骨颈骨折病例中，选择年龄、性别、随访时间均相仿的人工股骨头置换术患者５４例，全髋置换术患者６０例，进行回顾性分析。结果发现两种术式的住院时间相仿，早期并发症均较低；人工股骨头置换组的中、远期并发症、再手术率较高，全髋置换组手术创伤。假体费用较大，随访功能优良率较高。结论全髋置换术适合于５５岁以上、有移位的头下型患者，人工股骨头置换术适合高龄或全身情况较差者。

The Treatment of the Femoral Neck Fractures With Hemiarthroplasty and Total Hip Replacement

Objective To evaluate the value of hemiarthroplasty or total hip replacement for thetreatment of fractures of the femoral neck. Methods Fifty-four cases of the femoral neck fractures treated byhemiarthroplasty and 60 cases by total hip replacement between 1990 and 1996 were reviewed. Results Theresults show that the time of hospitalization between the two groups was similar, and the complications at theearly stage were not remarkable. The complications and secondary surgery rate were relatively higher in thegroup of hemiarthroplasty, while the surgical trauma was more severe, the prosthesis was more expensive and thefunction was better in the group of total hip replacement. Conclusion The results suggest that total hip re-placement is suitable for the patients older than 55 years with the subcapital fracture or the displaced fracture ofthe femoral neck, and hemiarthroplasty is suitable for the elders with systemic diseases.