小切口外侧入路髋关节置换术在股骨颈骨折中的治疗价值(1)
【摘要】 目的：探讨小切口外侧入路髋关节置换术在股骨颈骨折中的治疗价值。方法：选取本院100例股骨颈骨折患者，按随机数字表法分为小切口组与常规切口组，各50例。小切口组采取小切口外侧入路髋关节置换术，常规切口组采用常规切口髋关节置换术。比较两组手术相关情况及随访1、2、3年的Harris评分、功能性步态评价(functional gait assessment，FGA)评分及髋关节功能优良率。
结果：小切口组术中出血量、住院时间及住院总费用均低于对照组(P<0.05)。小切口组随访1、2、3年的FGA评分明显高于常规切口组(P<0.05)。小切口组随访1、2年的Harris评分均明显高于常规切口组(P<0.05)。小切口组随访1、2年的优良率为78%、84%高于常规切口组的58%、66%(P<0.05)。
结论：小切口外侧入路髋关节置换术治疗股骨颈骨折的创伤小、术后切口疼痛轻、术后恢复快，其早期髋关节功能优于常规切口入路。
【关键词】 股骨颈骨折; 小切口; 外侧入路; 髋关节置换术
The Value of Femoral Neck Fracture with Small Incision Lateral Approach Hip Replacement/LI Zhiping.//Medical Innovation of China，2019，16(22)：-164
【Abstract】 Objective：To explore the value of small incision lateral approach hip arthroplasty in the treatment of femoral neck fractures.Method：100 cases of femoral neck fracture in our hospital were selected.According to the random number table method they were divided into small incision group and conventional incision group，50 cases in each group.The small incision group treated with hip replacement by lateral approach of small incision and the conventional incision group treated with hip replacement by conventional incision.The surgical related conditions，Harris score，functional gait assessment(FGA)score and the excellent and good rate of hip joint function were compared between the two groups after 1，2，3 years follow-up.Result：The amount of bleeding，length of stay and total cost of hospitalization in the small incision group were lower than those in the conventional incision group(P<0.05).The FGA score followed up for 1，2，3 years in the small incision group was significantly higher than that in the conventional incision group(P<0.05).The Harris score followed up for 1 and 2 years in the small incision group was significantly higher than that in the conventional incision group(P<0.05).In the small incision group，the excellent and good rate of follow-up for 1，2 years was 78%，84% higher than 58% and 66% of the conventional incision group(P<0.05).Conclusion：Small incision lateral hip arthroplasty for femoral neck fracture has less trauma，less incision pain and faster recovery.Its early hip function is better than that of conventional incision.
【Key words】 Femoral neck fracture; Small incision; Lateral approach; Hip arthroplasty
First-author’s address：First People’s Hospital of Wuxue City，Wuxue 435400，China
doi：10.3969/j.issn.1674-4985.2019.22.042
髋关节置换术是股骨颈骨折患者的首选治疗方案，其在加快術后功能恢复和减少再次手术等方面优于内固定术[1-2]。半髋关节置换术由于术中出血多、关节脱位率高、术后关节活动范围受限等不足，造成患者术后康复慢、生活质量受到较大影响[3]。全髋关节置换术(total hip arthroplasty，THA)在减少并发症方面具有明显优势，成为股骨颈骨折的理想手术方式，但由于入路方式较多，效果也不尽相同[4-6]。随着微创技术在临床的推广应用，小切口(≤10 cm)手术受到外科医生的青睐，但临床对于小切口外侧入路(orthopadisehe chirurgie munchen，OCM)全髋关节置换术是否优于标准切口置换术的术后疗效尚无定论[7-8]。因此，本文开展相关研究，现报道如下。, 百拇医药(李智平)
结果：小切口组术中出血量、住院时间及住院总费用均低于对照组(P<0.05)。小切口组随访1、2、3年的FGA评分明显高于常规切口组(P<0.05)。小切口组随访1、2年的Harris评分均明显高于常规切口组(P<0.05)。小切口组随访1、2年的优良率为78%、84%高于常规切口组的58%、66%(P<0.05)。
结论：小切口外侧入路髋关节置换术治疗股骨颈骨折的创伤小、术后切口疼痛轻、术后恢复快，其早期髋关节功能优于常规切口入路。
【关键词】 股骨颈骨折; 小切口; 外侧入路; 髋关节置换术
The Value of Femoral Neck Fracture with Small Incision Lateral Approach Hip Replacement/LI Zhiping.//Medical Innovation of China，2019，16(22)：-164
【Abstract】 Objective：To explore the value of small incision lateral approach hip arthroplasty in the treatment of femoral neck fractures.Method：100 cases of femoral neck fracture in our hospital were selected.According to the random number table method they were divided into small incision group and conventional incision group，50 cases in each group.The small incision group treated with hip replacement by lateral approach of small incision and the conventional incision group treated with hip replacement by conventional incision.The surgical related conditions，Harris score，functional gait assessment(FGA)score and the excellent and good rate of hip joint function were compared between the two groups after 1，2，3 years follow-up.Result：The amount of bleeding，length of stay and total cost of hospitalization in the small incision group were lower than those in the conventional incision group(P<0.05).The FGA score followed up for 1，2，3 years in the small incision group was significantly higher than that in the conventional incision group(P<0.05).The Harris score followed up for 1 and 2 years in the small incision group was significantly higher than that in the conventional incision group(P<0.05).In the small incision group，the excellent and good rate of follow-up for 1，2 years was 78%，84% higher than 58% and 66% of the conventional incision group(P<0.05).Conclusion：Small incision lateral hip arthroplasty for femoral neck fracture has less trauma，less incision pain and faster recovery.Its early hip function is better than that of conventional incision.
【Key words】 Femoral neck fracture; Small incision; Lateral approach; Hip arthroplasty
First-author’s address：First People’s Hospital of Wuxue City，Wuxue 435400，China
doi：10.3969/j.issn.1674-4985.2019.22.042
髋关节置换术是股骨颈骨折患者的首选治疗方案，其在加快術后功能恢复和减少再次手术等方面优于内固定术[1-2]。半髋关节置换术由于术中出血多、关节脱位率高、术后关节活动范围受限等不足，造成患者术后康复慢、生活质量受到较大影响[3]。全髋关节置换术(total hip arthroplasty，THA)在减少并发症方面具有明显优势，成为股骨颈骨折的理想手术方式，但由于入路方式较多，效果也不尽相同[4-6]。随着微创技术在临床的推广应用，小切口(≤10 cm)手术受到外科医生的青睐，但临床对于小切口外侧入路(orthopadisehe chirurgie munchen，OCM)全髋关节置换术是否优于标准切口置换术的术后疗效尚无定论[7-8]。因此，本文开展相关研究，现报道如下。, 百拇医药(李智平)