全髋与半髋关节置换术治疗老年股骨颈骨折的临床分析(1)
摘要：目的 分析全髋关节置换术与半髋关节置换术治疗老年股骨颈骨折的临床疗效。方法 回顾性分析108例老年股骨颈骨折患者的临床资料，其中观察组56例，采取全髋关节置换术治疗；对照组52例，采取半髋关节置换术治疗；综合评价两组患者的临床疗效，并作对比。结果 观察组手术时间、住院时间长于对照组，术中失血量、术后引流量大于对照组，并发症发生率小于对照组，差异具有统计学意义(P<0.05)；手术后观察组髋关节功能Harris评分大于对照组，疗效优良率大于对照组，差异具有统计学意义(P<0.05)。结论 全髋关节置换与半髋关节置换治疗老年股骨颈骨折相比，虽然创伤较大、手术时间较长以及出血量相对较多，但髋关节功能明显优于半髋关节置换术且术后并发症少。临床上应尽量选择全髋关节置换术治疗老年股骨颈骨折，除非患者年龄>75岁，预期寿命短，活动量低股骨颈移位骨折才采用半髋置换术。
关键词：全髋关节置换术；半髋关节置换术；老年股骨颈骨折
Abstract：Objective To analyze the clinical effect of the treatment of senile femoral neck fracture after total hip arthroplasty and total hip arthroplasty. Methods A retrospective analysis of the clinical data of 108 cases of elderly patients with femoral neck fracture，56 cases of observation group were taken，total hip replacement therapy；52 cases in control group were taken semi hip replacement therapy； comprehensive evaluation the clinical efficacy of the two groups，and compared. Results In the observation group， operation time， hospitalization time was longer than the control group，intraoperative blood loss， postoperative drainage volume is greater than the control group，the complication rate is lower than the control group，the difference was statistically significant (P<0.05)；postoperative observation group Harris hip score higher than that of control group.The curative rate was higher than the control group，the difference was statistically significant(P<0.05). Conclusion The total hip arthroplasty and total hip arthroplasty for femoral neck fracture，although more trauma，hand The operation time is longer and the relatively large amount of bleeding， but the hip function was significantly better than the semi hip replacement and less postoperative complications.The clinical should choose total hip arthroplasty for femoral neck fractures in the elderly，except in patients older than 75 years old，short life expectancy，low activity of femoral neck fractures was hemiarthroplaaties replacement.
, 百拇医药
Key words：Total hip arthroplasty；Hemiarthroplasty；Femoral neck fracture in the elderly
老年股骨頸骨折是指股骨头下至股骨颈基底部之间的骨折，作为老年人的常见骨科类疾病，约占全部骨折5%，65岁以上的老年人中，髋部骨折占全身骨折的23.79%，其中股骨颈骨折占53%[1]；与骨质疏松导致的骨质量下降有关，当遭受轻微扭转暴力即可发生骨折。其治疗方法有多种，GardenⅠ、Ⅱ型股骨颈骨折常规采取闭合复位空心钉、内固定，但仍会有不能早期负重、股骨头坏死、骨折不愈合等并发症，部分患者需二次手术；老年股骨颈移位骨折，由于股骨头的血液循环已严重破坏，股骨头坏死发生率很高，股骨头置换术广泛用于治疗老年股骨颈骨折，由于半髋关节置换术后疼痛发生率高于全髋置换，远期存在翻修，作为影响疗效、预后的重要因素。全髋关节置换术逐渐替代半髋关节置换术，用于治疗老年股骨颈骨折，采用类似髋关节的假体置换病灶的关节面，达到恢复髋关节功能，可降低髋关节翻修率，能进一步改善预后[2，3]。对此，本研究旨在分析全髋关节置换术与半髋关节置换术治疗老年股骨颈骨折的临床疗效。
, 百拇医药
1 资料与方法
1.1一般资料 回顾性分析我院自2008年5月～2016年8月收治的108例老年股骨颈骨折患者的临床资料。观察组56例，男26例，女30例，年龄62～85岁，平均(68.8±4.5)岁；Garden分型：Ⅱ型14例，Ⅲ型25例，Ⅳ型17例；骨折原因：摔伤41例，撞击伤15例。对照组52例，男24例，女28例，年龄63～82岁，平均(67.9±4.2)岁；Garden分型：Ⅱ型13例，Ⅲ型25例，Ⅳ型14例；骨折原因：摔伤40例，撞击伤12例。纳入标准：符合老年股骨颈骨折的诊断标准，具有明确的骨折原因，伴有不同程度的症状、体征，经DR及CT检查证实；符合Garden分型。排除标准：不符合上述标准，合并严重的心脑血管疾病、其他类型的骨折；两组患者的一般资料无统计学差异。, 百拇医药(高技连 杨正芳)
关键词：全髋关节置换术；半髋关节置换术；老年股骨颈骨折
Abstract：Objective To analyze the clinical effect of the treatment of senile femoral neck fracture after total hip arthroplasty and total hip arthroplasty. Methods A retrospective analysis of the clinical data of 108 cases of elderly patients with femoral neck fracture，56 cases of observation group were taken，total hip replacement therapy；52 cases in control group were taken semi hip replacement therapy； comprehensive evaluation the clinical efficacy of the two groups，and compared. Results In the observation group， operation time， hospitalization time was longer than the control group，intraoperative blood loss， postoperative drainage volume is greater than the control group，the complication rate is lower than the control group，the difference was statistically significant (P<0.05)；postoperative observation group Harris hip score higher than that of control group.The curative rate was higher than the control group，the difference was statistically significant(P<0.05). Conclusion The total hip arthroplasty and total hip arthroplasty for femoral neck fracture，although more trauma，hand The operation time is longer and the relatively large amount of bleeding， but the hip function was significantly better than the semi hip replacement and less postoperative complications.The clinical should choose total hip arthroplasty for femoral neck fractures in the elderly，except in patients older than 75 years old，short life expectancy，low activity of femoral neck fractures was hemiarthroplaaties replacement.
, 百拇医药
Key words：Total hip arthroplasty；Hemiarthroplasty；Femoral neck fracture in the elderly
老年股骨頸骨折是指股骨头下至股骨颈基底部之间的骨折，作为老年人的常见骨科类疾病，约占全部骨折5%，65岁以上的老年人中，髋部骨折占全身骨折的23.79%，其中股骨颈骨折占53%[1]；与骨质疏松导致的骨质量下降有关，当遭受轻微扭转暴力即可发生骨折。其治疗方法有多种，GardenⅠ、Ⅱ型股骨颈骨折常规采取闭合复位空心钉、内固定，但仍会有不能早期负重、股骨头坏死、骨折不愈合等并发症，部分患者需二次手术；老年股骨颈移位骨折，由于股骨头的血液循环已严重破坏，股骨头坏死发生率很高，股骨头置换术广泛用于治疗老年股骨颈骨折，由于半髋关节置换术后疼痛发生率高于全髋置换，远期存在翻修，作为影响疗效、预后的重要因素。全髋关节置换术逐渐替代半髋关节置换术，用于治疗老年股骨颈骨折，采用类似髋关节的假体置换病灶的关节面，达到恢复髋关节功能，可降低髋关节翻修率，能进一步改善预后[2，3]。对此，本研究旨在分析全髋关节置换术与半髋关节置换术治疗老年股骨颈骨折的临床疗效。
, 百拇医药
1 资料与方法
1.1一般资料 回顾性分析我院自2008年5月～2016年8月收治的108例老年股骨颈骨折患者的临床资料。观察组56例，男26例，女30例，年龄62～85岁，平均(68.8±4.5)岁；Garden分型：Ⅱ型14例，Ⅲ型25例，Ⅳ型17例；骨折原因：摔伤41例，撞击伤15例。对照组52例，男24例，女28例，年龄63～82岁，平均(67.9±4.2)岁；Garden分型：Ⅱ型13例，Ⅲ型25例，Ⅳ型14例；骨折原因：摔伤40例，撞击伤12例。纳入标准：符合老年股骨颈骨折的诊断标准，具有明确的骨折原因，伴有不同程度的症状、体征，经DR及CT检查证实；符合Garden分型。排除标准：不符合上述标准，合并严重的心脑血管疾病、其他类型的骨折；两组患者的一般资料无统计学差异。, 百拇医药(高技连 杨正芳)
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