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投稿时间：2021-12-05 网络发布日期：2022-06-20
投稿时间：2021-12-05 网络发布日期：2022-06-20
中文摘要: 目的 探讨关节置换与内固定治疗老年患者股骨颈骨折的早期临床疗效。方法 回顾性选取2018年1月至2019年3月南京江北医院骨科中心收治的老年股骨颈骨折的患者43例，按照治疗方式不同分为关节置换组（行全髋关节置换术或人工股骨头置换术，n=22）和内固定组（行动力髋螺钉内固定术或空心螺钉内固定术，n=21），观察比较两组患者手术时间、术中出血量、术后6周、12周及24周髋关节Harris评分、术后12周及24周髋关节功能优良率、术后并发症发生率。结果 两组患者均顺利完成手术。关节置换组患者手术时间短于内固定组，差异具有统计学意义（P<0.05）；两组患者术中出血量比较，差异无统计学意义（P>0.05）；术后6周、12周随访时，关节置换组患者髋关节Harris评分高于内固定组，差异具有统计学意义（P<0.05）；两组患者术后24周随访时髋关节Harris评分比较，差异无统计学意义（P>0.05）；术后12周随访时，关节置换组患者髋关节功能优良率高于内固定组，差异具有统计学意义（72.72% vs 4.76%， P<0.05）；术后24周随访时，关节置换组患者髋关节功能优良率与内固定组比较差异无统计学意义（100.00% vs 85.71%， P>0.05）；关节置换组患者术后并发症发生率略低于内固定组，差异无统计学意义（4.55% vs 28.57%， χ2=2.959，P=0.085）。结论 关节置换与内固定治疗老年股骨颈骨折均有效，关节置换术可以早期恢复髋关节功能。
Abstract:Objective To investigate the early clinical effect of joint replacement and internal fixation in the treatment of femoral neck fracture in elderly patients. Methods A total of 43 elderly patients with femoral neck fracture treated in the Orthopaedic Center of Nanjing Jiangbei Hospital from January 2018 to March 2019 were retrospectively selected and divided into joint replacement group (received total hip replacement or femoral head replacement，n=22) and internal fixation group (received dynamic hip screw fixation or cannulated screw fixation，n=21) according to different treatment methods. The operation time, intraoperative bleeding, Harris score of hip joint at 6, 12 and 24 weeks after operation, excellent and good rate of hip joint function at 12 and 24 weeks after operation and the incidence of postoperative complications were compared between the two groups. Results All patients successfully completed the operation. The operation time in the joint replacement group was shorter than that in the internal fixation group (P<0.05). There was no significant difference between the two groups in the amount of intraoperative bleeding and Harris score of hip joint at 24 weeks’ follow-up (P>0.05). The Harris score of hip joint in the joint replacement group was higher than that in the internal fixation group at 6 and 12 weeks after operation (P<0.01). The excellent and good rate of hip joint function in the joint replacement group was higher than that in the internal fixation group (72.72% vs 4.76%, P<0.01). At 24 weeks’ follow-up, the excellent and good rate of hip function in the joint replacement group was similar to that in the internal fixation group (100.00% vs 85.71%, P>0.05). The incidence of postoperative complications in the joint replacement group was slightly lower than that in the internal fixation group, but the difference was not significant (4.55% vs 28.57%, χ2=2.959， P>0.05). Conclusion Joint replacement and internal fixation are effective in the treatment of femoral neck fractures in the elderly. Joint replacement can restore hip function early.
keywords: Femoral neck fracture Joint replacement Internal fixation Elderly Hip function Postoperative complication
文章编号： 中图分类号：R683.42 文献标志码：A
基金项目:
| Author Name | Affiliation |
| WANG Fang, QIU FU-ping, ZHAO Xiao-long, TIAN Ji-wei, WANG Bin | Orthopaedic Center, Nanjing Jiangbei Hospital Affiliated to Nantong University, Nanjing, Jiangsu 210048, China |
引用文本：
王芳，邱福平，赵晓龙，田纪伟，王斌.关节置换与内固定治疗老年患者股骨颈骨折的早期临床疗效[J].中国临床研究,2022,35(6):814-818.
王芳，邱福平，赵晓龙，田纪伟，王斌.关节置换与内固定治疗老年患者股骨颈骨折的早期临床疗效[J].中国临床研究,2022,35(6):814-818.