骨水泥型人工半髋与全髋关节置换治疗高龄股骨颈骨折的比较

背景：采用人工半髋关节置换治疗老年股骨颈骨折还存在一些争议。 目的：观察骨水泥型人工半髋关节置换治疗高龄股骨颈骨折的临床治疗效果，并与人工全髋关节置换对比。 方法：回顾性分析2009年1月至2010年6月的23例高龄股骨颈骨折行人工关节置换患者的临床资料，其中采用骨水泥型人工半髋关节置换的患者11例，人工全髋关节置换的患者12例。比较骨水泥型人工全髋关节置换与人工半髋关节置换患者的下床活动时间、Harris评分，以及围手术期并发症的发生率。 结果与结论：所有患者均获得12-18个月随访，骨水泥型人工半髋关节置换组治疗后主动直腿抬高角度、治疗后下床时间、治疗后早期并发症发生率、治疗后1周Harris评分优于人工全髋关节置换组；治疗后6周、3个月、6个月的Harris评分两组间差异无显著性；但骨水泥型人工半髋关节置换组远期髋关节疼痛的发生率高于人工全髋关节置换组。因此，作者认为高龄股骨颈骨折患者应用骨水泥型人工半髋关节置换后近期疗效较好，但远期综合疗效尚需进一步验证。

Cementless total hip arthroplasty versus hemiarthroplasty for the treatment of old femoral neck fracture

BACKGROUND：There is controversy on the treatment of old femoral neck fracture with hemiarthroplasty.
OBJECTIVE：To observe the clinical effect of cementless hemiarthroplasty in the treatment of old femoral neck fracture, and to compare with total hip arthroplasty.
METHODS：A retrospective analysis was performed on the clinical data of 23 old femoral neck fracture patients treated by artificial joint replacement from January 2009 to June 2010. Among the 23 patients, 11 cases were treated with cementless hemiarthroplasty, and 12 cases were treated with total hip arthroplasty. The time for off-bed activity, Harris score and the incidence of perioperative complications were compared between cementless total hip arthroplasty and hemiarthroplasty.
RESULTS AND CONCLUSION：Al the patients were fol owed-up for 12-18 months. The active straight leg raising angle, time for off-bed activity, incidence of early postoperative complications and Harris score at 1 week after treatment of the cementless hemiarthroplasty group were better than those of the total hip arthroplasty group;there were no significant differences in Harris score at 6 weeks, 3 and 6 months between two groups;the incidence of forward hip pain of the cementless hemiarthroplasty group was higher than that of the total hip arthroplasty group. So, we general y think that cementless hemiarthroplasty has better short-term effect in the treatment of old femoral neck fracture, but the long-term integrated efficacy needs to be further identified.