全髋关节置换与内固定治疗股骨颈骨折临床疗效比较.docVIP

精品论文 参考文献 全髋关节置换与内固定治疗股骨颈骨折临床疗效比较 屈铁男 陈洪瑜 王志刚 　　(青岛经济技术开发区第一人民医院骨科 山东青岛 266555) 　　【摘要】对施行内固定或全髋关节置换术后的新鲜老年股骨颈骨折患者的临床随访，总结所取得的经验和教训。材料及方法:我们对1997年6月-2004年10月间施行内固定或全髋关节置换术的老年患者（65岁以上）进行随访，获得随访58例，其中A组24例行空心拉力螺钉固定；B组34例行人工全髋关节置换。对其手术后功能恢复情况平均随访时间3.8年。结果：34例全髋关节置换（THA）患者术后优良率91.2%（22例）；24例内固定（IF）患者术后优良率62.5%；A组严重并发症中有7例为骨折不愈合、股骨头坏死2例。结论:对于老年股骨颈骨折的治疗，全髋关节置换是一种有效的治疗方式；如果能够有效降低较高的骨折不愈合率，多枚中空拉力螺钉内固定也是一种可行的选择。 　　【中图分类号】R687 【文献标识码】A 【文章编号】1672-5085（2014）23-0156-02 　　Comparison of internal fixation with total hip replacement for displaced femoral neck fractures. 　　CHEN Hongyu * ，JIA Wei-dong * et al. Dept of Orthopedics, First Peoples Hospital of Qingdao Economy and Technique Development Zone, Qingdao, Shandong 266555 　　【Abstract】Objective: controlled trials performed postoperatively have shown that a primary total hip replacement is superior to internal fixation for the treatment of a femoral neck fracture in a relatively healthy, mentally competent, elderly patient. The primary aim of the present study was to evaluate the outcomes. METHODS: 58 patients who had an acute femoral neck fracture were randomly allocated to be treated with total hip replacement or internal fixation. 24 cases (A group)were treated by IF,and 34 cases(B group) were treated by THR. RESULTS: At the 3.8 years follow-up evaluation, the rate of hip complications was 8.8% in the patients treated with total hip replacement and 37.5% in those treated with internal fixation .The hip function was significantly better and the decline in health-related quality of life was less pronounced in the arthroplasty group than it was in the fixation group CONCLUSIONS: Compared with internal fixation, primary total hip replacement provides a better outcome for mentally competent elderly patients with a femoral neck fracture. If we can decrease the rate of the un-union ，then internal fixation was also good method. 　　1. 材料及方法 　　我们对1997年6月-2004年10月间施行内固