摘要
目的比较分析直接前侧入路全髋与半髋关节置换术治疗高龄股骨颈骨折的临床效果。方法抽取鹤壁煤业(集团)有限责任公司总医院2020年2月至2023年2月收治的高龄股骨颈骨折患者76例,按随机数字表法分为观察组与对照组,每组38例。对照组采用直接前侧入路半髋关节置换术,观察组采用直接前侧入路全髋关节置换术。比较两组骨折愈合优良率、髋关节功能评分、术后恢复情况(假体髋臼前倾角、假体髋臼外展角)、Fugl-Meyer运动功能测评法(FMA)评分、日常生活能力量表(ADL)评分及并发症发生率。结果观察组骨折愈合优良率(94.74%,36/38)高于对照组(78.95%,30/38),P<0.05。术后3个月,观察组疼痛、功能、畸形、活动度评分高于对照组(P<0.05);术后,观察组假体髋臼前倾角、假体髋臼外展角大于对照组(P<0.05);术后3个月,观察组FMA、ADL评分高于对照组(P<0.05)。观察组并发症发生率(13.16%,5/38)和对照组(7.89%,3/38)比较差异未见统计学意义(P>0.05)。结论与直接前侧入路半髋关节置换术比较,直接前侧入路全髋关节置换术治疗高龄股骨颈骨折患者,可提高骨折愈合率,改善髋关节功能、下肢运动功能,提高日常生活能力。
Objective To compare the effect of total hip arthroplasty and hemiarthroplasty via direct anterior approach in the treatment of femoral neck fractures in the elderly.Methods A total of 76 elderly patients with femoral neck fractures treated in General Hospital of Hebi Coal Industry(Group)Co.,Ltd.from February 2020 to February 2023 were selected,and they were divided into observation group and control group according to random number table method,with 38 cases in each group.The control group was treated by hemiarthroplasty via direct anterior approach,and the observation group was treated by total hip arthroplasty via direct anterior approach.The excellent and good rate of fracture healing,hip joint function score,postoperative recovery(prosthesis acetabular anteversion angle,prosthesis acetabular abduction angle),the Fugl-Meyer assessment(FMA)score,activities of daily living(ADL)score,and incidence of complications were compared between the two groups.Results The excellent and good rate of fracture healing in the observation group(94.74%,36/38)was higher than that in the control group(78.95%,30/38),P<0.05.Three months after operation,the scores of pain,function,deformity and activity in the observation group were higher than those in the control group(P<0.05).After operation,the prosthesis acetabular anteversion angle and prosthesis acetabular abduction angle in the observation group were higher than those in the control group(P<0.05).Three months after operation,the FMA and ADL scores of the observation group were higher than those of the control group(P<0.05).There was no significant difference in the incidence of complications between the observation group(13.16%,5/38)and the control group(7.89%,3/38),P>0.05.Conclusions Compared with hemiarthroplasty via direct anterior approach,total hip arthroplasty via direct anterior approach in the treatment of elderly patients with femoral neck fracture can improve the fracture healing rate,hip joint function,lower limb motor function,and daily life ability.
作者
杨金发
宋善新
周果
刘勇
王利圣
葛世凯
Yang Jinfa;Song Shanxin;Zhou Guo;Liu Yong;Wang Lisheng;Ge Shikai(Department of Orthopedics,General Hospital of Hebi Coal Industry(Group)Co.,Ltd.,Hebi 458000,China)
出处
《中国实用医刊》
2023年第22期17-20,共4页
Chinese Journal of Practical Medicine
作者简介
通信作者:杨金发,Email:yangjinfa2023@163.com。
