回顾性分析72例老年股骨颈囊内移位骨折患者关节置换术

目的 探讨老年股骨颈囊内移位骨折患者行人工髋关节置换术的方法及其疗效.方法 回顾性分析72例老年股骨颈囊内移位骨折患者的病例资料,其中Garden Ⅲ型35例,Garden Ⅳ型37例;按手术方法分4组：骨水泥全髋置换术11例,非骨水泥拿髋置换术12例,骨水泥半髋置换术30例,非骨水泥半髋置换术19例.术后定期随访X线片及Hams评分.结果 随访时间25-114个月,中位随访时间93个月,行人工髋关节置换术者Harris评分优良率为92.19%.结论 老年股骨颈骨折患者应尽可能接受手术治疗;老年股骨颈囊内移位骨折、Garden Ⅲ和Garden Ⅳ型患者宜行人工髋关节置换术;不同手术方法中期效果及并发症比较,差异无统计学意义.

Retrospective analysis of hip joint replacement for displaced intracapsular femoral neck fractures in the 72 elderly cases

Objective To study the methods and efficacy of artificial joint replacement for displaced intracapsular femoral neck fractures in the elderly. Methods 72 elderly cases （35 cases of garden Ⅲ type and 37 cases of garden Ⅳ type）, which were treated with artificial hip joint replacement, were analyzed retrospectively. All cases were divided into cemented total arthroplasty group （11 cases）, uncemented arthroplasty group （12 cases）, cemented hemiarthroplasty group （30 cases） and uncemented hemiarthroplasty group （19 cases）. All cases underwent X-ray check and Harris score postoperatively in a regular follow-up way. Results The follow~up periods were 25-114 months （ median 93 months）. Harris score of patients with artifical hip joint replacement was 92.19%. Conclusion For the displaced intracapsular femoral neck fractures in the elderly, surgical treatment is necessary. The patients of Garden Ⅲ and Garden Ⅳ types should be treated with artificial hip joint replacement.