髋关节置换治疗老年移位股骨颈骨折的术式选择

目的 探讨老年(＞65岁)移位股骨颈骨折人工关节置换术的适应症及术式选择.方法 2003年1月-2008年6月共收治108例移位股骨颈骨折患者,年龄65～90岁,平均76.8岁,全部骨折为Garden Ⅲ或Ⅳ型.全髋关节置换(THA组)62例,人工双极股骨头置换(BH组)46例,随访36～60个月,平均45.6个月.分...

Options of arthroplasty for treatment of displaced femoral neck fracture in elder

Objective To explore options and proper indication of arthroplasty for treatment of displaced femoral neck fracture in the elderly patients. Methods From January 2003 to June 2008,108 cases with displaced femoral neck fracture were operated by arthroplasty, at average age of 76.8 years (65～90 years). All fractures were Garden's type Ⅲ orⅣ. 62 cases(THA Group)were total hip arthroplasty and 46 cases (BH Group)were bipolar hemiarthroplasty. All cases were followed up for 36-60 months, with an average of 45.6 months. The operation duration, blood loss and hip function (Harris score) postoperative 1 year and 3 years were compared. Results Operative duration: group THA(97.42±12.27), group BH (71.74±10.86);, blood loss: group THA(343.71±64.10), group BH(306.41±74.33); 1 year Harris: group THA(89.21±5.98), group BH(87.71±5.76); 3-year Harris:group THA(87.54±6.42), group BH(82.63±9.39). There were significant differences in operative duration and blood loss between the two groups (P＜0.05); there was no significant difference in Harris score of postoperation for 1 year (P＞0.05) but there was significant difference(P＜0.05) postoperation for 3 years between the two groups. Conclusions There was a higher risk of total hip arthroplasty than hemiarthroplasty, but it has better long term effect. Total hip arthroplasty was a primary choice for healthy and active patients, while hemiarthroplasty was only recommended for patients with poor health and limited activity before fracture.