摘要
目的 回顾性分析组配式股骨假体髋关节翻修治疗在全髋关节置换术后股骨假体周围骨折中的应用效果。方法 回顾性选取2018年4月至2019年4月上海市第八人民医院收治的股骨假体周围骨折患者60例作为研究对象。其中30例患者采用骨水泥假体髋关节翻修治疗,设定为对照组,采用组配式股骨假体髋关节翻修治疗的30例患者设定为观察组,并随访6个月。观察两组患者手术情况、手术前后哈里斯髋关节评分(Harris hip score,HHS)及帕克-帕尔莫移动评分(Parker Palmer mobility score,PPMS)、手术前后VAS评分及骨折愈合情况。结果 所有患者手术顺利,且无发生特殊并发症及不良事件。观察组手术时间、术中出血量、输血量、住院时间[(65. 12±22. 13) min、(1 986. 52±875. 63) ml、(955. 25±520. 17) ml、(12. 98±5. 11) d]显著优于对照组[(76. 38±24. 64) min、(2 437. 42±953. 87) ml、(1 226. 44±553. 09) ml、(15. 52±5. 83) d],差异有统计学意义(P <0. 05)。观察组术后HHS及PPMS评分分别为(73. 66±16. 05)分,(8. 37±2. 13)分,显著优于术前的(4. 46±1. 34)分、(0. 83±0. 27)分,差异具有统计学意义(P<0. 05);观察组术后HHS评分及PPMS评分显著优于对照组的(66. 42±14. 83)分、(7. 15±1. 96)分,差异有统计学意义(P <0. 05);观察组患者的骨折愈合时间为(14. 29±6. 3)周,与对照组的(15. 03±7. 5)周相比差异无统计学意义(P> 0. 05)。治疗后观察组患者的VAS评分为(2. 86±0. 99)分,显著优于对照组的(3. 73±1. 28)分,差异具有统计学意义(P <0. 05)。结论 组配式股骨假体髋关节翻修治疗全髋关节置换术后股骨假体周围骨折,术后患者HHS和PPMS评分明显提高,VAS评分明显降低,临床效果比较满意,值得临床推广应用。
Objective To analyze the effect of the combined femoral prosthesis hip revision in the treatment of femoral prosthetic fractures after total hip replacement.Methods Sixty patients with femoral periprosthetic fractures admitted in Shanghai Eighth People's Hospital from April 2018 to April 2019 were retrospectively selected as the research objects.Thirty patients were treated with cemented prosthetic hip joint revision and set as control group,and 30 patients treated with combined femoral prosthesis hip revision were set as observation group.The surgical status,Harris hip score(HHS)and Parker Palmer mobility score(PPMS),VAS score and fracture healing before and after surgery were observed in the two groups.Results All patients had a successful operation without special complications or adverse events.The operation time,intraoperative blood loss,blood transfusion volume,and hospital stay in observation group were(65.12±22.13)min,(1986.52±875.63)ml,(955.25±520.17)ml,and(12.98±5.11)d,which were significantly better than the control group[(76.38±24.64)min,(2437.42±953.87)ml,(1226.44±553.09)ml,(15.52±5.83)d],the difference was statistically significant(P<0.05).The postoperative HHS score and PPMS score of the observation group were(73.66±16.05)points,(8.37±2.13)points were significantly better than those in the control group(66.42±14.83)points,(7.15±1.96)points,the difference was also statistically significant(P<0.05).HHS score and PPMS score in the observation group were significantly better than those in the control group,and the difference was also statistically significant(P<0.05).The VAS score of patients in the observation group before treatment was(6.65±0.72)points.The VAS score of the observation group after treatment was(2.86±0.99)points,which was significantly better than that of the hollow nail group(3.73±1.28)points,and the difference was statistically significant(P<0.05).Conclusion The combined femoral prosthesis and hip joint revision for the treatment of femoral prosthetic fractures after total hip arthroplasty has significantly improved HHS and PPMS scores,significantly reduced VAS scores,and satisfactory clinical results.It is worthy of clinical application.
作者
沈骏
高田田
杨杰
SHEN Jun;GAO Tian-tian;YANG Jie(Department of Orthopedics,Shanghai NO.8 People's Hosptial,Shanghai 200235,China)
出处
《临床和实验医学杂志》
2020年第8期879-882,共4页
Journal of Clinical and Experimental Medicine
基金
上海市科学技术委员会科普基金支持项目(编号:18dz2300500)。
关键词
全髋关节置换术
股骨假体周围骨折
组配式股骨假体
髋关节翻修
Total hip replacement
Periprosthetic fracture of femur
Combined femoral prosthesis
Revision of hip joint
