内固定与全髋关节置换治疗移位型股骨颈骨折的中期疗效

发布时间：2018-04-19 00:25

本文选题：内固定 + 关节置换　；参考：《实用医学杂志》2017年10期

【摘要】：目的:比较闭合复位空心钉内固定(IF)与全髋关节置换术(THA)治疗移位型股骨颈骨折的临床疗效。方法:将128例老年移位型股骨颈骨折患者按手术方式分为两组,其中IF组61例,THA组67例。比较两组患者手术及住院相关指标。术后对患者进行定期随访,采用Zuckerman功能恢复量表(FRS)评估患者髋部功能,采用欧洲五维健康量表(EQ-5D)评估患者生活质量。末次随访时统计患者因骨折产生的医疗费用。结果:与THA相比IF创伤小、手术快、住院时间短(P0.05),但并发症发生率较高。术后所有患者均完成3年以上随访,随访期间两组患者死亡率无明显差异(P0.05)。术后各随访时间点THA组患者髋部功能均优于IF组(P0.05),但两组患者生活质量均无明显差异(P0.05)。3年内THA组和IF组患者因骨折产生的医疗费用分别为61 174元和41 772元。结论 :IF和THA均是治疗老年移位型股骨颈骨折的有效方法,与IF相比THA虽然创伤大、治疗费用高,但并发症发生率低,短期内患者髋部功能可明显提高。
[Abstract]:Objective: to compare the clinical effects of closed reduction and hollow nail fixation (IFF) and total hip arthroplasty (THA) in the treatment of displaced femoral neck fractures.Methods: 128 elderly patients with displaced femoral neck fracture were divided into two groups according to the operation mode, including 61 cases in if group and 67 cases in tha group.The related indexes of operation and hospitalization were compared between the two groups.The hip function was assessed by Zuckerman functional recovery scale (FRS) and the quality of life (QOL) was evaluated by European five dimensional Health scale (EQ-5D).At the last follow-up, the patient's medical expenses due to fracture were counted.Results: compared with THA, if had less trauma, faster operation and shorter hospitalization time (P 0.05), but the incidence of complications was higher.All patients were followed up for more than 3 years. There was no significant difference in mortality between the two groups (P 0.05).The hip function of THA group was better than that of if group at all follow-up time points, but there was no significant difference in quality of life between the two groups. The medical expenses caused by fracture in THA group and if group within 3 years were 61,174 yuan and 41,772 yuan, respectively.Conclusion both if and THA are effective methods for the treatment of displaced femoral neck fractures in elderly patients. Compared with if, THA has a lower incidence of complications and can improve the hip function in a short period of time.
【作者单位】：兰州大学第二医院骨科;北京积水潭医院创伤骨科;兰州大学第二医院骨科研究所;
【分类号】：R687.3

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