摘要
目的探索人工髋关节置换术在中老年GardenⅢ和Ⅳ型股骨颈骨折中应用价值。方法选取扬州市江都中医院2018年4月至2021年4月收治的98例中老年GardenⅢ和Ⅳ型股骨颈骨折患者为研究对象,分为研究组(人工髋关节置换术,n=48)和对照组(空心钉内固定术,n=48),比较两组患者手术相关参数,Harris和ADL评分,以及术中并发症。结果研究组和对照组的手术时间无明显差异(P>0.05);研究组患者术中失血量高于对照组(P<0.001);切口长度比对照组长(P<0.001);术中透视次数、下地时间、患肢负重时间和住院时间均少于对照组(P<0.001)。手术前,两组患者Harris评分和ADL评分均无明显差异(P>0.05);治疗后,两组患者Harris评分和ADL评分均明显升高,且研究组Harris评分和ADL评分上升程度更明显,研究组并发症发生率明显低于对照组(P<0.05)。结论空心钉内固定术与人工髋关节置换术治疗中老年GardenⅢ和Ⅳ型股骨颈骨折效果均较好,其中人工髋关节置换术后下床时间短,患者术后髋关节功能和自主生活能力恢复更好,且并发症少。
Objective To explore the application value of artificial hip replacement in middle-aged and elderly patients with GardenⅢandⅣfemoral neck fractures.Methods 98 middle-aged and elderly patients with femoral neck fracture admitted to Jiangdu Hospital of Traditional Chinese Medicine from April 2018 to April 2021 were selected as the study subjects,and were divided into the study group(artificial hip replacement,n=48)and the control group(hollow nail internal fixation,n=48).The operative parameters,Harris and ADL scores,and intraoperative complications of the two groups were compared.Results There was no significant difference in operation time between the study group and the control group(P>0.05).The intraoperative blood loss in the study group was higher than that in the control group(P<0.001).Incision length of the study group was longer than that of the control group(P<0.001).The Times of fluoroscopy,the time spent on the ground(P<0.001),the time of weight-bearing on the affected limb,and the length of hospital stay in the study group were all lower than those in the control group(P<0.001).Before operation,there were no significant differences in Harris score and ADL score between 2 groups(P>0.05).After treatment,the Harris score and ADL score of both groups were significantly increased,and the increase degree of Harris score and ADL score of the study group was more obvious than those of the control group(P<0.001).The complication rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion Hollow nail internal fixation and artificial hip arthroplasty are effective in the treatment of GardenⅢandⅣfemoral neck fractures of middle-aged and elderly patients,and the time of getting out of bed after artificial hip arthroplasty is short,the recovery of hip function and independent living ability is good,and the complications are fewer.
作者
仇正鹏
QIU Zhengpeng(Department of Orthopedics and Traumatology,Jiangdu Hospital of Traditional Chinese Medicine,Yangzhou 225200,China)
出处
《中华灾害救援医学》
2024年第6期634-637,共4页
Chinese Journal of Disaster Medicine
关键词
股骨颈骨折
外科手术
人工髋关节置换术
femoral neck fractures
surgical procedures,operative
artificial hip arthroplasty
