股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术的比较

目的 通过对股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术临床结果的比较,为股骨颈骨折手术方式的选择提供依据.方法 回顾性分析随访2年的43例股骨颈骨折内固定失败后冉次行髋关节置换术(A组)和52例股骨颈骨折直接行髋关节置换术(B组)的临床资料,比较两组患者的手术情况、术后并发症、术后2年的髋关节功能和生活质量.采用Charnley评分法评定手术侧髋关节的疼痛、活动度和运动情况.采用欧洲生活质晕评分EQ-5D评分体系评定病人的健康生活质量.结果 A组和B组的手术时间、术中出血量、术后2年的髋关节功能评分和生活质量评分分别为:1.9±0.2和1.4±0.2小时、525.6±50.8和462.3±47.8ml、13.4±2.3和15.2±2.4、0.67±0.26和0.72±0.25分,两者比较均具有统计学意义(P<0.05).结论 内固定失败后再次行髋关节置换术临床效果较股骨颈骨折直接行髋关节置换术差,对于股骨颈骨折内固定容易出现骨折不愈合或缺血坏死的病例宜直接选择髋关节置换术.

Comparison of primary hip replacement secondary replacement after failed internal fixation in the treatment of femoral neck fractures

Objective To explore the difference of the outcomes of primary hip replacement and secondary replacement after failed internal fixation in the treatment of femoral neck fractures for optimal choice of operation method for femoral neck fractures.Methods 43 patients with a secondary hip replacement after failed internal fixation(Group A) and 52 patients with a primary hip replacement(Group B) in the treatment of femoral neck fractures were retrospectively analyzed.All patients were followed up at least 2 year...