小切口双极股骨头置换治疗老年股骨颈骨折疗效分析
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摘要
目的探讨分析小切口双极股骨头置换治疗老年股骨颈骨折的临床疗效。方法回顾性分析该科2015年9月至2017年1月采用小切口水泥型双极股骨头置换治疗的34例70岁以上老年股骨颈骨折患者的临床资料。观察手术时间,出血量,术后引流瓶出血量,术后3、12个月Harris髋关节功能评分,评估其疗效。结果 34例患者手术平均时间为(71.56±10.38)min,手术中出血量为(100.29±28.87)mL,术后引流量为(96.00±25.01)mL。术后3个月Harris髋关节功能评分为(83.15±6.79)分,术后12个月Harris髋关节功能评分为(83.71±6.74)分,二者比较,差异无统计学意义(P>0.05)。结论采用小切口骨双极股骨头置换治疗老年股骨颈骨折,术后未发生明显并发症,创伤小,能早期恢复患者受伤前活动,避免发生卧床相关并发症,可明显提高患者生活质量。
Objective To investigate and analyze the clinical effect of small incision bipolar femoral head replacement in the treatment of senile femoral neck fracture.Methods The clinical data of 34 cases elderly patients with femoral neck fracture treated with small-incision cement bipolar femoral head replacement from September 2015 to January 2017 were retrospectively analyzed.The operative time,the amount of bleeding,the amount of bleeding from the drainage bottle after the operation,and the Harris hip function score at 3 and 12 months after the operation were observed to evaluate the efficacy.Results The average operative time was(71.56±10.38)min,intraoperative blood loss was(100.29±28.87)mL,and postoperative drainage was(96.00±25.01)mL.Harris hip function score 3 months after surgery was(83.15±6.79)points,and Harris hip function score 12 months after surgery was(83.71±6.74)points.There was no significant difference between them(P>0.05).Conclusion Small-incision bipolar femoral head replacement is used for the treatment of femoral neck fracture in the elderly,and no obvious complications occurre after the surgery.The wound is small,and the activity before injury could be restored in an early stage,so as to avoid bedby-related complications and significantly improve the quality of life of the patients.
Objective To investigate and analyze the clinical effect of small incision bipolar femoral head replacement in the treatment of senile femoral neck fracture.Methods The clinical data of 34 cases elderly patients with femoral neck fracture treated with small-incision cement bipolar femoral head replacement from September 2015 to January 2017 were retrospectively analyzed.The operative time,the amount of bleeding,the amount of bleeding from the drainage bottle after the operation,and the Harris hip function score at 3 and 12 months after the operation were observed to evaluate the efficacy.Results The average operative time was(71.56±10.38)min,intraoperative blood loss was(100.29±28.87)mL,and postoperative drainage was(96.00±25.01)mL.Harris hip function score 3 months after surgery was(83.15±6.79)points,and Harris hip function score 12 months after surgery was(83.71±6.74)points.There was no significant difference between them(P>0.05).Conclusion Small-incision bipolar femoral head replacement is used for the treatment of femoral neck fracture in the elderly,and no obvious complications occurre after the surgery.The wound is small,and the activity before injury could be restored in an early stage,so as to avoid bedby-related complications and significantly improve the quality of life of the patients.
引文
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[9]胥德政,任百芳.全髋关节与单双极人工股骨头置换治疗老年股骨颈骨折的疗效比较[J].中国骨与关节损伤杂志,2011,26(6):522-523.
[10]魏志辉,赵波,何超,等.骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折的Meta分析[J].中国矫形外科杂志,2016,24(14):1287-1294.
[11]李涛,翁习生,周磊,等.骨水泥型股骨头置换治疗高龄患者股骨颈骨折有效性与安全性随机对照研究的Meta分析[J].中华创伤骨科杂志,2013,15(8):645-652.
[12]肖志勤.骨水泥双极人工股骨头置换治疗高龄股骨颈骨折疗效分析[J].中华创伤骨科杂志,2010,12(7):693-694.
[13]张先龙,何耀华,王琦,等.老年股骨颈骨折的小切口微创人工全髋关节置换[J].中华创伤骨科杂志,2004,6(5):506-508.
[2]郝林杰,邱裕生,张育民,等.全髋与半髋置换术治疗老年人股骨颈骨折疗效比较[J].实用骨科杂志,2017,23(2):118-123.
[3]邓江,韩小松,韩建华,等.后外侧小切口在全髋关节置换术中的应用[J].遵义医学院学报,2004,27(3):265-266.
[4] HARRIS WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty.An end-result study using a new method of result evaluation[J].J Bone Joint Surg Am,1969,51(4):737-755.
[5]王雷,刘庆宽,张元民,等.全髋与半髋置换治疗老年股骨颈骨折的比较[J].中国组织工程研究,2013,17(22):4013-4017.
[6] MACAULAY W,YOO RS,PARSLEY B,et al.Displaced femoral neck fracture:there a standand of care[J].Orthopedics,2007,30(9):748-749.
[7]危杰,毛玉江,贾正中.中空加压螺丝钉治疗新鲜股骨颈骨折212例[J].中华创伤杂志,2000,16(3):142-144.
[8]李军,黄恩申.人工髋关节置换治疗老年骨质疏松性股骨颈骨折[J].中国骨质疏松杂志,2009,15(5):354-356.
[9]胥德政,任百芳.全髋关节与单双极人工股骨头置换治疗老年股骨颈骨折的疗效比较[J].中国骨与关节损伤杂志,2011,26(6):522-523.
[10]魏志辉,赵波,何超,等.骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折的Meta分析[J].中国矫形外科杂志,2016,24(14):1287-1294.
[11]李涛,翁习生,周磊,等.骨水泥型股骨头置换治疗高龄患者股骨颈骨折有效性与安全性随机对照研究的Meta分析[J].中华创伤骨科杂志,2013,15(8):645-652.
[12]肖志勤.骨水泥双极人工股骨头置换治疗高龄股骨颈骨折疗效分析[J].中华创伤骨科杂志,2010,12(7):693-694.
[13]张先龙,何耀华,王琦,等.老年股骨颈骨折的小切口微创人工全髋关节置换[J].中华创伤骨科杂志,2004,6(5):506-508.