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后路小切口人工全髋关节置换治疗老年人股骨颈骨折
Hits: 1884   Download times: 1354   Received:October 10, 2006    
作者Author单位UnitE-Mail
祝海炳 ZHU Hai-bing 舟山市骨伤医院骨科,浙江舟山316000 Department of Orthopaedics Surgery,Zhoushan Orthopaedics and Traumatology Hospital of TCM,Zhoushan 316000,Zhejiang,China zszhb@yahoo.com.cn 
蒋垚 JIANG Yao 上海交通大学附属第六人民医院骨科  
龙亨国 ZHU Hai-bing 舟山市骨伤医院骨科,浙江舟山316000 Department of Orthopaedics Surgery,Zhoushan Orthopaedics and Traumatology Hospital of TCM,Zhoushan 316000,Zhejiang,China  
沈灏 SHEN Hao 上海交通大学附属第六人民医院骨科  
刘玖行 LIU Jiu-xing 舟山市骨伤医院骨科,浙江舟山316000 Department of Orthopaedics Surgery,Zhoushan Orthopaedics and Traumatology Hospital of TCM,Zhoushan 316000,Zhejiang,China  
期刊信息:《中国骨伤》2007年20卷,第9期,第594-596页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:观察后路小切口人工全髋关节置换术(小切口-THA)治疗老年股骨颈骨折的临床效果。

方法:本组24例65岁以上股骨颈骨折患者,女13例,男11例;年龄65~78岁,平均73.4岁。均为外伤后股骨颈头下型骨折,位线差,其中Garden分型为Ⅲ型10例,Ⅳ型14例,全部应用后路小切口技术行全髋关节置换术。

结果:术后所有病例随访10~24个月,平均13个月。平均手术时间80min,手术切口平均长8.0cm,平均输血300ml,无局部及全身并发症出现。按UCLA(University of California Los Angeles)髋关节功能评分标准,本组UCLA评分由术前平均(11.0±3.8)分升至术后平均(24.3±4.5)分(P<0.01)。本组优17例,良4例,一般3例,优良率为87.5%。

结论:后路小切口技术具有创伤小、出血少、恢复快的特点,可获得与常规后路相同的治疗效果,尤其适合老年股骨颈骨折患者。
[关键词]:关节成形术,置换,髋  外科手术,微创性  股骨颈骨折  老年人
 
Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fracture in the aged people
Abstract:

Objective: To obaserve the therapeutic results of total hip arthroplasty (THA) with posterior minimal incision for the treatment of femoral neck fractures in the aged people.

Methods: Twenty-four patients with femoral neck fractures were treated in the study,among which 13 patients were female and 11 patients were male,ranging in age from 65 to 78 years,with an average of 73.4 years.All the fractures were subcapital type with bad location of the fracture line,which were caused by trauma.According to Garden classification,10 patients were type Ⅲ fracture,14 patients were type Ⅳ fracture.All the patients were treated with posterior minimally invasive total hip arthroplasty.

Results: All the patients were followed up.The average duration of follow-up was 13 months(range,10 to 24 months).The average duration of the operation was 80 minutes.The average length of incision was 8.0 cm.The average blood transfusion was 300 ml.No complications occurred.The therapeutic effects were evaluated based on UCLA (University of California Los Angeles) hip score.The average UCLA scores of all the patients elevated from 11.0±3.8 preoperatively to 24.3±4.5 postoperatively (P<0.01).Seventeen patients obtained an excellent result,4 good,3 bad.The excellent and good rate was 87.5%.

Conclusion: THA with posterior minimal incision has the advantages of less soft tissue damage,less blood loss and faster recovery,which can improve hip joint function as good as that of traditional posterior approach,especially good for the elderly patients with femoral neck fractures.
KEYWORDS:Arthroplasty replacement,hip  Surgical procedures,minimally invasive  Femoral neck fracture  Aged
 
引用本文,请按以下格式著录参考文献:
中文格式:祝海炳,蒋垚,龙亨国,沈灏,刘玖行.后路小切口人工全髋关节置换治疗老年人股骨颈骨折[J].中国骨伤,2007,20(9):594~596
英文格式:ZHU Hai-bing,JIANG Yao,ZHU Hai-bing,SHEN Hao,LIU Jiu-xing.Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fracture in the aged people[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(9):594~596
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