摘要
目的探讨直接前方入路与后外侧入路髋关节置换术治疗老年股骨颈骨折合并帕金森的疗效。方法回顾性分析132例老年股骨颈骨折合并帕金森患者的临床资料,根据手术入路不同将患者后外侧入路组(64例)和直接前方入路组(68例)。术后随访12个月,比较2组患者手术时间、切口长度、术中出血量、术后开始负重时间、骨折愈合时间、Harris评分、髋部骨折功能恢复量表(FRS)评分、视觉模拟量表(VAS)评分及并发症。术后1 d,比较2组患者髋臼外展角、髋臼前倾角和股骨假体位置。结果直接前方入路组手术时间长于后外侧入路组(P<0.05),切口长度、术中出血量、术后开始负重时间短/少于后外侧入路组(P<0.05)。2组术后Harris评分、FRS评分均逐渐增高(P<0.05),VAS评分降低(P<0.05);直接前方入路组术后1个月、6个月、12个月Harris评分、FRS评分均高于后外侧入路组(P<0.05),VAS评分低于后外侧入路组(P<0.05)。2组术后髋臼外展角、髋臼前倾角、股骨假体居中率比较差异均无统计学意义(P>0.05),直接前方入路组术后并发症发生率低于后外侧入路组(P<0.05)。结论相比于后外侧入路,直接前方入路创伤小,患者疼痛少,术后恢复快,并发症发生率低,是老年股骨颈骨折合并帕金森病患者髋关节置换术较为理想的入路方式。
Objective To investigate the efficacy of direct anterior approach and posterolateral approach in the treatment of senile femoral neck fracture complicated with Parkinson’s disease.Methods The clinical data of 132 senile patients with femoral neck fracture complicated with Parkinson’s disease were analyzed retrospectively and patients were divided into the posterolateral approach group(with 64 cases)and the direct anterior approach group(with 68 cases)according to different surgical approaches.Patients were followed up for 12 months after surgery,the operation time,incision length,intraoperative blood loss,postoperative weight-bearing time,fracture healing time,Harris score,hip fracture functional recovery scale(FRS)score,visual analogue scale(VAS)score and complications were compared between the two groups.The acetabular abduction angle,acetabular anteversion angle and femoral prosthesis position 1 day after surgery were compared between the two groups.Results The operation time of the direct anterior approach group was longer than that of the posterolateral approach group(P<0.05),the incision length,intraoperative blood loss,postoperative weight-bearing time were shorter/less than those of the posterolateral approach group(P<0.05).Harris score and FRS score were increased gradually after surgery(P<0.05),VAS score was decreased in the two groups(P<0.05).Harris score and FRS score in the direct anterior approach group were higher than those of the posterolateral approach group(P<0.05),VAS score were lower than those of the posterolateral approach group 1 month,6 months,12 months after surgery(P<0.05).There was no statistically significant difference in acetabular abduction angle,acetabular anteversion angle or median rate of femoral prosthesis between the two groups after surgery(P>0.05),the incidence of postoperative complications of the direct anterior approach group was lower than that of the posterolateral approach group(P<0.05).Conclusion Compared with the posterolateral approach,the direct anterior appro
作者
贺国
王洪
毕岩
刘超
李季
HE Guo;WANG Hong;BI Yan;LIU Chao;LI Ji(Department of Orthopaedics,Panjin Central Hospital,Panjin Liaoning 124010,China)
出处
《局解手术学杂志》
2021年第7期638-642,共5页
Journal of Regional Anatomy and Operative Surgery
基金
辽宁省自然科学基金指导计划项目(20170428)。
关键词
髋关节置换术
股骨颈骨折
帕金森
直接前方入路
后外侧入路
hip arthroplasty
femoral neck fracture
Parkinson’s disease
direct anterior approach
posterolateral approach
