【摘要】 目的 比较人工关节置换术与AO加压空心螺钉术治疗老年人有移位股骨颈骨折的疗效。方法 将1995年5月～2004年11月我院收治的78例年龄在65周岁以上的有移位的新鲜股骨颈骨折患者进行回顾性研究，将病例分为A、B两组，A组为人工关节置换组，B组为AO加压空心螺钉治疗组。AO加压空心螺钉治疗组(内固定组)随访12～91个月，平均41.7个月，随访人工关节置换组12～96个月，平均40.3个月。结果 按Harris评分标准，A组术后优良率达到82.9%；B组内固定组优良率57.1%。术后远期并发症的发生率A组为19.5%；B组为42.9%。结论 人工关节置换术和AO加压空心螺钉均是治疗老年股骨颈骨折的有效方法，但人工关节置换术可提高老年人的生活质量，减低术后并发症的发生率，所以人工关节置换的效果优于AO加压空心螺钉。

    【关键词】 股骨颈骨折；老年人；人工关节置换；内固定

    Internal fixation and prothesis replacement in treatment of femoral neck fracture in elderly

    XU Feng,ZHANG Man-jiang,WANG Ming-li.

    The Second Hospital of Jilin University,Changchun 130041,China

    【Abstract】 Objective To compare the effects of hip arthroplasty and AO compressive cannular in treatment of the displaced fracture of femoral neck in elderly.Methods From 1995.5 to 2004.11, 78 elderly patients of over 65 years old with displaced femoral neck fracture(Garden Ⅲ Ⅳ) were operated with hip arthroplasty(Group A) and AO compressive cannular (Group B). The follow-up period of A ranged from 12 to 96 months(mean,40.3months).The follow-up period of B ranged from 12 to 91 months(mean,41.7month).Results According to Harris scoring system,There were 34 excellent or good cases(82.9%)in A group and 16 excellent or good cases(57.1%) in B group. There with 8 cases of postoperative complication in group A (19.5).There were 12 cases of postoperative complication in group B(42.9%).Conclusion Both hip arthroplasty and AO compressive cannular are reasonable choices for treatment of displaced femoral neck fracture in the elderly, but the results of group A is better than the group B. The rate of postoperative complication of group A is lower than the group B. So hip arthroplasty is a better way between two methods for the elderly with poor conditions. ......