全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的临床疗效对比研究

陈　帅　于立芹

淄博矿业集团有限责任公司中心医院骨科，山东淄博255120

全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的临床疗效对比研究

陈帅于立芹

淄博矿业集团有限责任公司中心医院骨科，山东淄博255120

目的比较全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折疗效。方法将2011年8月～2014年8月入住我院的资料完整的87例老年股骨颈骨折患者按照关节置换术类型分为全髋关节置换术组（n=43）与半髋关节置换术组（n=44）。比较两组临床优良率、手术情况、功能恢复情况及髋关节疼痛情况。结果（1）全髋关节置换术组优良率为90.70%（39/43），半髋关节置换术组优良率为90.90%（40/44），两组临床优良率比较差异无统计学意义（P＞0.05）；（2）除全髋关节置换术组手术时间显著长于半髋关节置换术组外，两组患者其余手术情况（包括术中出血量、术后失血量、总输血量、住院时间及并发症发生率）比较差异均无统计学意义（P＞0.05）；（3）对两组患者随访1年，两组患者行走情况比较差异无统计学意义（P＞0.05），但全髋关节置换术组患者疼痛程度显著小于半髋关节置换术组（P＜0.05）。结论全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折疗效相当，应根据患者实际情况选择合适的手术。

老年股骨颈骨折；全髋关节置换术；半髋关节置换术；疼痛

［Abstract］Objective To compare the effect of total hip arthroplasty and hemiarthroplasty in treatment of femoral neck fractures.Methods From August 2011 to August 2014 in our hospital，87 cases of femoral neck fracture were divided into total hip arthroplasty group（n=43）and partial hip arthroplasty group（n=44）.The clinical excellent rate，surgical cases，functional recovery and hip pain conditions were compared.Results（1）The excellent rate in total hip arthroplasty group was 90.70%（39/43），partial hip arthroplasty group was 90.90%（40/44），there was no significant difference between the two groups（P＞0.05）；（2）The operative time in the total hip arthroplasty group was significantly longer than that in the half hip arthroplasty group，there were no significant differences of the remaining surgery index including blood loss，postoperative blood loss，the total amount of blood transfusion，hospital time and complication rates between two groups（P＞0.05）；（3）Followed-up for one year，there was no significant difference of walking between the two groups（P＞0.05），but pain in the total hip arthroplasty group was significantly less than that in the half hip arthroplasty group（P＜0.05）.Conclusion Total hip arthroplasty and hemiarthroplasty in treatment of femoral neck fractures have similar curative effect，the appropriate operation should select according to the actual situation of the patient.

［Key words］Elderly femoral neck fractures；Total hip arthroplasty；Partial hip arthroplasty；Pain

股骨颈骨折多发生于老年人群，随着人口老龄化趋势的不断严峻，该病的临床发病率呈现出逐年升高的发展趋势［1］。老年人，特别是女性一般多存在骨质疏松症，骨折之后往往会继发骨折不愈合以及股骨头无菌性坏死的情况，其发病率可高达20%以上［2-3］。……