加压空心螺钉内固定与人工髋关节置换术治疗老年股骨颈骨折的疗效比较.pdfVIP

· 742 · THE JOURNALOFBONE 』 ! !! 垦 ! ： !： ：! ： ： 加压空心螺钉内固定与人工髋关节置换术 治疗老年股骨颈骨折的疗效比较 周来喜 。 许世存 郑廷忠 王庆生 · 论 著 · 摘要 目的 探讨加压空心螺钉内固定与人工髋关节置换术治疗老年股骨颈骨折 的价值。方法 从 6O岁以上股骨颈骨折病例 中选择年龄、性别、随访时间均相仿的内固定 72例 (IF组)，人工股骨头置换 98例 (FHA组 )，全髋关节置换 86例 (THR 组)，进行回顾性分析。结果 三组患者合并症、住院时间、关节功能、早期并发症方面无显著差异 (P0．05)；手术时间、 失血量、下地时间、远期并发症方面有显著差异 (P0．05)。内固定及人工股骨头置换中远期并发症及再手术率高，而全髋 关节置换早期并发症多，但随访功能优良率高。结论 内固定治疗适合 Garden I、I、II型的65岁以下患者，治疗要点是骨 折优良复位；人工股骨头置换适合65岁以上、全身情况较差的患者；全髋关节置换适合6O～8O岁、体质较好的患者。 关键词 股骨颈骨折 ；内固定 ；髋假体 Therapeutic Comparasion between Internal Fixation and Arthroplasty for Femoral Neck Fracture in Elderly Patients Zhou Laixi，Xu Shichun，Zheng Tingzhong，el a1．Department of Orthapaedics，Central Hospital，Shantou，Guangdong， 515031 Abstract 0bjective To explore the surgical methods and their value in treatment of femoral neck fractures in the elderly patients． Methods The patients over 60 years old)with femoral neck fracture were analyzed retrospectively．They were similar in age，sexual distinction and follow—up time，of which 72 cases were treafed with internal fixation(Group IF)，98 with femoral head arthroplasty (Group FHA)，and 86 wifh total hip joint replacement(Group THR)．Results In comparision of the coexisting diseases，duration of the hospitalization，join function and early stage complication，there was no difference in the three groups(P0．05)．While in compar— ision of operating time，blood loss，ambulation time and forward stage complication，there was a significant difference(P0．05)．In— ternal fixation and femoral head arthroplasty had higher rate of middle—forw ard stage complications and secondary surgery． And total hip joint replacement had more complications at the early stage，but its function was better．Conclusion Internal fixation is suitable for the patients(younger than 65)of Garden type I，I orⅢ，femoral head arthroplasty is suitable for the elders of over 65 with systemic dis— e_．asea，and total hip joint replacement is suitable for the patients arranged from 60 to 8O with