| 直接外侧入路和后外侧入路对股骨颈骨折患者术后再手术和脱位影响的相关性分析 |
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Received:April 20, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 关江 |
GUAN Jiang |
安康市人民医院骨科, 陕西 安康 725000 |
Department of Orthopaedics, Ankang People's Hospital, Ankang 725000, Shaanxi, China |
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| 蒋方杰 |
JINAG Fang-jie |
安康市人民医院骨科, 陕西 安康 725000 |
Department of Orthopaedics, Ankang People's Hospital, Ankang 725000, Shaanxi, China |
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| 赵灏 |
ZHAO Hao |
安康市人民医院骨科, 陕西 安康 725000 |
Department of Orthopaedics, Ankang People's Hospital, Ankang 725000, Shaanxi, China |
jimhaop@sina.com |
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| 期刊信息：《中国骨伤》2020年33卷，第1期，第43-46页 |
| DOI：10.3969/j.issn.1003-0034.2020.01.008 |
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目的：比较髋关节置换术直接外侧入路和后外侧入路对股骨颈骨折患者术后再手术和脱位的相关性，为寻找髋关节置换术治疗股骨颈骨折最佳入路的选择提供参考。
方法：选取2015年1月至2018年12月收治行髋关节置换术的266例股骨颈骨折患者，其中男154例，女112例，年龄58～74（69.8±8.1）岁。分别采用直接外侧入路和后外侧入路，每组133例。比较两组患者术后再手术率和脱位率的差异。应用Cox比例风险回归模型评估全髋关节置换术后再手术及脱位的潜在影响因素。
结果：直接外侧入路组的再手术率和脱位率均低于后外侧入路（P<0.05）。Cox比例风险回归模型结果显示，相对于直接外侧入路，后外侧入路具有更高的术后再手术率及脱位率，其相对风险比（95%CI）分别为，再手术［2.65（1.23-5.36），P=0.02］；脱位［5.15（1.68-9.15），P=0.01］。
结论：后外侧入路是髋关节置换术后再手术和脱位的影响因素，年龄、性别、认知功能障碍、置换位置、ASA评分等因素对再手术和脱位没有影响。 |
| [关键词]:关节成形术,置换,髋 股骨颈骨折 手术入路 再手术 脱位 |
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| Correlation analysis of the influence of direct lateral approach and posterolateral approach on reoperation and dislocation in patients with femoral neck fracture |
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Abstract:
Objective: To compare the relationship between direct lateral approach and posterolateral approach in the treatment of femoral neck fracture,and to provide reference for the choice of the best approach.
Methods: From January 2015 to December 2018,266 patients with femoral neck fracture underwent hip replacement were selected,including 154 males and 112 females,aged 58 to 74 (69.8±8.1) years. Direct lateral approach and posterolateral approach were used in 133 cases in each group. The difference of reoperation rate and dislocation rate between the two groups was compared. Cox proportional risk regression model was used to evaluate the potential factors of reoperation and dislocation after total hip replacement.
Results: The rate of reoperation and dislocation in direct lateral approach group was lower than that in posterolateral approach group(P<0.05). Cox proportional risk regression model showed that posterolateral approach had higher postoperative reoperation rate and dislocation rate than direct lateral approach,and its relative risk ratio(95%CI) was,reoperation[2.65(1.23-5.36),P=0.02];dislocation[5.15(1.68-9.15),P=0.01].
Conclusion: Posterolateral approach is the influencing factor of reoperation and dislocation after hip replacement. Age,gender,cognitive dysfunction,replacement position,ASA score and other factors have no effect on reoperation and dislocation. |
| KEYWORDS:Arthroplasty,replacement,hip Femoral neck fractures Operative approach Reoperation Dislocations |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 关江,蒋方杰,赵灏.直接外侧入路和后外侧入路对股骨颈骨折患者术后再手术和脱位影响的相关性分析[J].中国骨伤,2020,33(1):43~46 |
| 英文格式: | GUAN Jiang,JINAG Fang-jie,ZHAO Hao.Correlation analysis of the influence of direct lateral approach and posterolateral approach on reoperation and dislocation in patients with femoral neck fracture[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(1):43~46 |
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