两种手术方式治疗老年移位型股骨颈骨折的临床比较

目的比较股骨头置换和空心钉内固定在治疗老年移位型股骨颈骨折中的疗效和安全性。方法 2005年1月至2009年12月我院共收治65岁以上股骨颈骨折并移位的老年患者82例,按照手术方式将其分为两组:股骨头置换组32例,空心钉内固定组50例。比较两组患者的手术时间、出血量、术后并发症的发生率、术后1年的髋关节功能及再手术率。结果内固定组的手术时间、出血量明显少于股骨头置换组(P<0.05)。股骨头置换组和内固定组术后并发症的发生率分别为12.5%(4/32)、34.0%(17/50),再手术率分别为6.3%(2/32)、26.0%(13/50)。内固定组术后并发症的发生率及再手术率明显高于股骨头置换组,差异有统计学意义(P<0.05)。股骨头置换组髋关节功能的恢复情况优于内固定组(P<0.05)。结论对于65岁以上移位型股骨颈骨折的患者,如果入院时一般情况较好,预期寿命较长,股骨头置换与内固定相比是较好的选择。

Comparison of two different surgeries for displaced femoral neck fractures in elderly patients

Objective To compare the effectiveness and safety of hemiarthroplasty and internal fixation for displaced femoral neck fractures in elderly patients.Methods Eighty-two patients with displaced femoral neck fracture and age over 65 years treated from January 2005 to December 2009 were divided into two groups according to the surgical type they underwent,32 with hemiarthroplasty and 50 with internal fixation.The operating time,blood loss during the operation,postoperative complication rates,functions of the hi...