后侧小切口全髋关节置换治疗老年股骨颈骨折

目的对比后侧小切口和传统后外侧入路全髋关节置换术治疗老年股骨颈骨折的早期疗效。方法60岁以上新鲜移位的股骨颈骨折老年患者50例，随机分成2组：小切口组25例，经后侧小切口行全髋关节置换术；传统组25例，经传统后外侧入路。对两组的手术切口长度、手术时间、术中失血量、术后引流量、术后下地行走时间、并发症发生率、术后一周疼痛、术后6个月Harris评分等指标进行比较。结果小切口组出血量（215．12±41．51ml）较传统组（320．23±51．42ml）明显减少（P〈0．05）；术后疼痛评分为28．31±4．31分，较传统组（术后疼痛评分为45．38±6．45分）疼痛程度减轻，持续时间缩短；术后下地练习行走时间（9．42±2．03d）明显早于传统组（18．31±1．08d）（P〈0．05）；无围手术期死亡及静脉血栓形成。结论后侧小切口微创全髋置换术治疗老年股骨颈骨折，创伤小，围手术期出血少，切口小且不影响假体位置，术后可早期进行功能锻炼，比传统髋关节置换术式具有更优越的早期疗效。

Lateral mini-incision total hip arthroplasty for femoral neck fracture in old age patients

Objective To compare the early therapeutic effect between the mini-incision posterolateral approach and the standard posterolateral approach in the total hip arthroplasty used in the old age patients with displaced femoral neck fracture. Methods Fifty old patients who underwent displaced femoral neck fracture lately were divided into two groups. The average age was 71.5. In mini-incision（MIS） group, 25 patients underwent the mini-incision posterolateral approach in the total hip arthroplasty. In standard gronp, 25 patients underwent the standard posterolateral approach. Compared incision size, operating time, amount of bleeding, incidence of complications, postoperatative pain, Harris points and other indicators with the traditional hip replacement. Results The lateral mini-incision total hip arthroplasty is less trauma, less bleeding, postoperative pain, faster recovery. Conclusion The lateral mini-incision total hip arthroplasty has better early effect than traditional hip arthroplasty.