摘要
目的探讨经后外侧入路小切口髋关节置换治疗老年股骨颈移位骨折的经验体会。方法 2008年1月至2009年5月采用该方法治疗老年股骨颈移位骨折18例,其中男性6例,女性12例,年龄67-79岁,平均76.6岁。新鲜骨折17例,陈旧性骨折1例,双动股骨头置换5例,全髋13例。观察切口所需长度,手术时间,术中出血量,术后引流量及并发症,X线片观察假体位置,术后功能恢复及Harris评分。结果本组18例均获随访,随访时间3-16月,平均10.5月。切口长度7-10cm;手术时间60-110min;术中出血量150-250ml;术后引流量300-450ml,其中9例术后引流量超过450ml,予输血400-800ml。术后切口无感染、坐骨神经损伤、脱位、深静脉血栓形成等并发症。X片假体位置好,Harris评分,优良率83.3%。结论后外侧入路小切口髋关节置换术治疗老年股骨颈移位骨折是可行的,具有切口小,组织损伤小,术中出血少,手术时间短,并发症少等优点。
Objective To explore the effect of hip arthroplasty with posterolateral small-incision on displaced femoral neck fractures in the aged people.Methods Hip arthroplasty through a posterolateral small-incision was performed in 18 cases（18 hip joints） including 5 cases of double-acting femoral hid replacement and 13 cases of total hip replacement.There were 17 cases of fresh fractures and 1 case of old fracture.We recorded incision length,operative time,blood loss,postoperative drainage volume and complications.The clinical effects were evaluated with Harris score.Results All cases were followed up for 3-16 months（average 10.5 months）.The average length of incision was 8.9cm（range,7-10cm）.The mean surgical time was 90 minutes（range,60-110 minutes）.The average intraoperative blood loss was 180ml（150-250ml）.The mean postoperative drainage was 380ml（300-450ml）.As postoperative drainage was more than 450ml in 9 cases.The patients were given transfusions（400-800ml）.No complications such as incision infection,sciatic nerve injury,dislocation,deep vein thrombosis were encountered.The Harris hip scores showed excellent effect in 6 cases,good in 9 cases,fair in 3 cases and poor in 0 case,with a rate of excellent or good results of 83.3%.Conclusion The hip arthroplasty with posterolateral small-incision is available for displaced femoral neck fracture in the aged people,with minor soft tissue damage,less blood loss,shorter operative time,and acceptable complications.
出处
《西部医学》
2010年第8期1408-1410,共3页
Medical Journal of West China
关键词
小切口
髋关节
置换
老年
股骨颈
骨折
Small-incision
Hip
Arthroplasty
The aged people
Femoral neck fractures
