SuperPATH approach combined shank and neck femoral head replacement for elderly femoral neck fractures and analysis of postoperative lower limb length
Objective To observe the early efficacy and postoperative changes in lower limb length following bipolar femoral head replacement using the SuperPATH approach with an integrated stem neck femoral straight stem prosthesis.Methods Between September 2015 and October 2020,75 patients with femoral neck fracture were treated.The length of incision,operation time,operative blood loss,unloaded activity time and complications were recorded.Harris hip function score and visual analogue scale(VAS)score were compared before and 1,4,12,and 24 weeks and 1 and 2 years after operation.A pelvic X-ray was taken within one week after surgery,the vertical distance from the line connecting the vertices of the tears on both sides to the top edge of the lesser trochanter was measured,and any difference in length between the two lower limbs was determined.At the last follow-up,plain CT scans of the pelvis and upper middle femur were performed to observe the position and bone growth of the femoral prosthesis.Results All patients were followed up after surgery,with a follow-up time of 24-85 months,with a mean of 56.7 months.The incision length was 7.85±0.51 cm,the surgical time was 89.29±26.84 minutes,the intraoperative bleeding volume was 78.67±56.79 mL,and the first landing time was 1.43±0.49 days.The Harris hip joint function score and VAS score were compared at various time points before and after surgery and the differences were statistically significant(P＜0.05).There were no statistically-significant differences between Harris and VAS scores at 12 and 24 months postoperatively(P＞0.05),but all the other differences were statistically significant(P＜0.05).The difference of lower limb length in all 75 patients was 3.57±4.44 mm after surgery,which was a significant difference compared with that before surgery(-17.61±7.86 mm;P＜0.05).At the last follow-up,CT plain scan of the pelvis and upper middle femur showed good placement of the femoral prosthesis,and the cross-section showed good bone growth around the prosthesis.The SuperPATH approach shank neck femoral head replacement resulted in less trauma,less pain,and a faster recovery,and the early curative effect was satisfactory.As the preoperative imaging evaluation and intraoperative measurement and other means repeatedly verified,limb length can be effectively adjusted under limited exposure to prevent unequal length of the lower limbs.Conclusion The SuperPATH approach shank and neck femoral head replacement causes less trauma,less pain,a faster recovery,and the early curative effect is satisfactory.Through preoperative imaging evaluation,intraoperative measurement and other means,we repeatedly verified that limb length can be effectively adjusted under limited exposure to prevent unequal length of the lower limbs.
万方数据
维普
