老年移位型股骨颈骨折内固定失败后行全髋关节置换术的疗效
The efficacy of total hip arthroplasty after failed internal fixation of displaced femoral neck fractures in the elderly
张文营 1张斌青 1倘艳锋2
作者信息
- 1. 湖南中医药大学研究生院,湖南 长沙 410208;河南省洛阳正骨医院(河南省骨科医院)影像中心,河南 洛阳 471000
- 2. 河南省洛阳正骨医院(河南省骨科医院)髋关节外科诊疗中心,河南 洛阳 471000
- 折叠
摘要
目的 探讨老年移位型股骨颈骨折内固定失败后行全髋关节置换术(THA)的疗效.方法 采用THA治疗29 例老年移位型股骨颈骨折内固定失败患者.记录手术情况以及术后并发症发生情况、疼痛VAS评分、髋关节Harris评分、SF-36 生活质量评分.结果 患者均获得随访,时间 12～20 个月.手术时间 72～136(99.52±20.22)min,切口长度8.2～16.4(13.15±2.27)cm,术中出血量 220～516(340.83±83.91)ml,术后引流量121～296(193.07±56.12)ml;住院时间11～21(16.41±3.08)d.术后发生 6 例并发症,其中 2 例下肢肌间静脉血栓形成,1 例谵妄,1 例尿潴留,2 例假体后脱位,均经对症治疗后治愈.末次随访时,疼痛VAS评分、Harris评分、SF-36 评分均较THA术前改善(P＜0.01).结论 THA是治疗老年移位型股骨颈骨折内固定失败后的有效措施,可明显改善髋关节功能及患者生活质量;但应预防术后假体脱位,提示术者需要做好术前评估和规划、术中细致操作,患者术后需要规范康复锻炼.
Abstract
Objective To investigate the effect of total hip arthroplasty(THA)after failed internal fixation of dis-placed femoral neck fracture in the elderly.Methods THA was used to treat the failed internal fixation after dis-placed femoral neck fracture in 29 elderly patients.The operative conditions and postoperative complications,pain VAS,hip Harris score and SF-36 quality of life score were recorded.Results All patients were followed up for 12～20 months.The operative time was 72～136(99.52±20.22)min,the incision length was 8.2～16.4(13.15±2.27)cm,the intraoperative blood loss was220～516(340.83±83.91)ml,and the postoperative drainage volume was 121～296(193.07±56.12)ml.The duration of hospitalization was 11～21(16.41±3.08)days.Postoperative complications occurred in 6 cases,including 2 cases of lower extremity intermuscular venous thrombosis,1 case of de-lirium,1 case of urinary retention,2 cases of prosthesis posterior dislocation,all of which were cured after symptomatic treatment.At the last follow-up,the pain VAS,Harris score and SF-36 score were significantly improved,compared with those before THA(P＜0.01).Conclusions THA is an effective measure for treatment of the failure internal fix-ation of elderly displaced femoral neck fracture,which can significantly improve hip function and quality of life of pa-tients.However,it is necessary to prevent the dislocation of prosthesis after surgery,which suggests that the surgeon should do a good job in preoperative evaluation and planning,intraoperative careful operation,postoperative standard rehabilitation exercise.
关键词
移位型股骨颈骨折/全髋关节置换/内固定失败/老年人Key words
displaced femoral neck fractures/total hip arthroplasty/failure of internal fixation/aged引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据