全髋关节置换与双极半髋关节置换治疗股骨颈骨折的比较

目的比较全髋关节置换(THA)与双极半髋关节置换(BHA)治疗股骨颈骨折的疗效。方法对1992年1月~2002年1月采用人工髋关节置换治疗股骨颈骨折50例进行回顾性分析,其中THA27例,平均随访61个月,BHA23例,平均随访69个月。结果两组病例的住院时间及并发症的比较,差别无显著性意义(P>0.05),BHA组的手术时间及失血量少于THA组(P<0.05)。两组病例的早期Harris功能评分无明显差异(P>0.05),而全髋关节置换的中、远期疗效优于双极半髋关节置换。结论全髋关节置换适用于大多数老年人的股骨颈骨折,并发症少,关节功能好,疗效满意,应优先选用;双极半髋关节置换适用于身体虚弱的高龄患者。

Comparative analysis of total hip arthroplasty and bipolar hemiarthroplasty for treatment of femoral neck fractures

Objective To compare the curative effect of the total hip arthroplasty (THA) and bipolar hemiarthroplasty(BHA) for the treatment of the femoral neck fractures. Methods Fifty cases with femoral neck fracture underwent hip prosthesis replacement were reviewed retrospectively. Of all cases, 27 cases were treated with THA and followed up for the average of 61 months,23 cases with BHA and followed up for the average of 69 months. Results There was no significant difference between two groups in hospitalization time and complications (P>0.05). The operation time and blood loss in BHA group were less than that in THA group (P<0.05). There was no significant difference between two groups in the Harris score at short-term follow-up (P>0.05), while the function in the group of THA was better than that in the group of BHA at the intermediate-term and long-term follow-up. Conclusion THA is suitable for most old patients with femoral neck fracture, which is a safe and satisfactory method and should be the first choice; BHA is only fit for senile cases with poor conditions.