外侧入路小切口全髋关节置换治疗老年股骨颈骨折_临床医学论文.docVIP

外侧入路小切口全髋关节置换治疗老年股骨颈骨折_临床医学论文 外侧入路小切口全髋关节置换治疗老年股骨颈骨折_临床医学论文 作者：窦亚栋 赵德伟　郭林 王本杰 　　【论文关键词】外侧小切口　人工全髋关节置换　老年股骨颈骨折 　　【论文摘要】目的 探讨外侧小切口全髋关节置换术在治疗高龄股骨颈骨折的临床疗效。方法 采用外侧小切口全髋关节置换术治疗老年股骨颈骨折30例。GardenⅢ型17例，Ⅳ型13例。其中男18例，女12例，年龄70～82岁，平均75.3岁。结果 手术切口长6～10cm，平均8cm，手术时间为56～80min，平均为68min，术中出血量为200～500ml，平均380ml。随访12～24个月，平均随访16个月，术后一年Harris评分平均为95.1分，无切口感染、骨折、神经血管损伤、深静脉血栓形成、髋关节脱位、假体松动等并发症。结论 外侧小切口全髋关节置换术治疗老年股骨颈骨折是一种理想的方法,具有手术切口短，创伤小，出血少，瘢痕少，术后功能恢复快等特点。 　　【Abstract】Objective To investigate the clinical effect with lateral mini-incision THR for treatment the femoral neck fractures in senile patients. Methods Thirty senile femoral neck fractures cases were collected， which is including GardenⅢ17 and Garden Ⅳ 13.There were 18 males and 12 females， and the average age was 75.3 year. All patients were treated with lateral mini-incision THR. Resulte Incision is 6～10cm，average 8cm，operation time 56～80 min， average 68 minute，the average intraoperation blood loss was 380ml(range from 200～500ml), All patients were followed up from 12～24 months (average 16 months).. The clinical effect was evaluated according to Harris score system after a year， average is 95.1，All patients have no complications including incision infection， bone fracture ， injury of blood vessel and nerve， deep venous thrombosis ，dislocation of hip joint prosthesis etc. Conclusion Lateral mini-incision THR for treatment of the femoral neck fractures in senile patients is a ideal method, which has advantages of recovery and few complications because of few scar，little trauma and blood loss. 　　【Key Words】Femoral neck fractures;Lateral mini-incision; THR; Senile　　老年股骨颈骨折卧床时间长，骨折不愈合和股骨头坏死发生率较高。人工全髋关节置换术是治疗老年股骨颈骨折的有效治疗手段，可以早期活动，早期负重行走，提高生活质量。临床应用越来越广泛，对其要求也在不断增加。除对提高植入物的使用寿命外，还要求减少手术的创伤性，缩短康复时间。本文报告了采用外侧入路小切口人工全髋关节置置换术在治疗老年股骨颈骨折的临床疗效。 　　1临床资料与方法 　　1.1一般资料：本组共30例，其中男18例，女12例，年龄70～82岁，平均75.3岁。所有患者均为股骨颈骨折，受伤至手术时间为5～14d，平均8d。骨折类型：头下型13例，头颈型8例，经颈型9例。骨折移位GardenⅢ型17例，Ⅳ型13例。骨折合并不同程度的内科疾病24例，占80%，其中高血压11例，冠心病8例，脑血管后遗症2例，糖尿病9例，慢性支气管炎并肺气肿7例，其