摘要
背景:目前髋关节置换已成为治疗老年股骨颈骨折的主要方式,但尚无简单、有效、可重复性好的方法降低术后双下肢不等长的发生率。目的:探讨头颈比法在股骨颈骨折人工股骨头置换过程中均衡双下肢长度差异的有效性。方法:以2017年1月至2019年3月于滨州医学院附属医院接受单侧人工股骨头置换的132例高龄股骨颈骨折患者作为研究对象,其中2017年1月至2018年2月收治的68例患者采用传统方法于术中均衡下肢长度,称为传统组;2018年3月至2019年3月收治的64例患者采用头颈比法于术中均衡下肢长度,称为改良组。对两组患者的手术时间、住院时间、术后双下肢长度差异、末次随访髋关节功能Harris评分及术后并发症进行回顾性对比分析。结果与结论:①所有患者均获随访,随访时间6-20个月;②改良组在手术时间、住院时间及手术后并发症等方面与传统组差异无显著性意义(P>0.05),但在均衡下肢长度差异上改良组(4.56±3.07)mm较传统组(6.09±3.31)mm优势显著,差异有显著性意义(P<0.05);③末次随访改良组的髋关节功能Harris评分(92.36±3.35)分高于传统组(91.09±3.41)分,差异有显著性意义(P<0.05);④提示高龄单侧股骨颈骨折患者应用头颈比法行人工股骨头置换方法简单、有效,对均衡术后双下肢不等长、促进髋关节功能恢复效果良好。
BACKGROUND:Hip replacement has become the main treatment for femoral neck fracture in the elderly at present,but there is no simple,effective or reproducible method to reduce the incidence of unequal length of lower limbs.OBJECTIVE:To investigate the effectiveness of head-neck ratio in balancing the difference of lower extremity length in femoral neck fracture replacement.METHODS:From January 2017 to March 2019,132 aged patients undergoing unilateral artificial femoral head replacement for femoral neck fracture were selected as the research object.From January 2017 to February 2018,68 cases were treated by traditional method of equilibrium of lower limb length,known as the traditional group.From March 2018 to March 2019,64 patients with head and neck for spell equilibrium in lower limb length were included in the improved group.The operation time,hospital stay,postoperative double lower limbs length difference,the last follow-up function Harris hip score and complications after surgery were selected for retrospective analysis in both groups.RESULTS AND CONCLUSION:(1)All patients were followed up for 6-20 months.(2)There were no statistically significant differences between the modified group and the traditional group in operation time,hospital stay,and postoperative complications(P>0.05),but the improved group(4.56±3.07)mm had a significant advantage over the traditional group(6.09±3.31)mm in the balanced length of lower limbs,and the difference between the two groups was statistically significant(P<0.05).(3)At the last follow-up,Harris score of hip function in the improved group(92.36±3.35)points was higher than that in the traditional group(91.09±3.41)points,and the difference between the two groups was statistically significant(P<0.05).(4)These results indicate that artificial femoral head replacement for elderly patients with unilateral femoral neck fracture using head-neck ratio is simple and effective.It is effective in balancing the unequal length of lower limbs after surgery and promoting the recovery of hip function.
作者
宋凯凯
杜刚强
李朋
蒋昇源
宫智浩
张志伟
张锴
Song Kaikai;Du Gangqiang;Li Peng;Jiang Shengyuan;Gong Zhihao;Zhang Zhiwei;Zhang Kai(Department of Orthopedic Trauma,Affiliated Hospital of Binzhou Medical College,Binzhou 256600,Shandong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第18期2805-2809,共5页
Chinese Journal of Tissue Engineering Research
关键词
股骨颈骨折
股骨头置换
髋关节
下肢不等长
并发症
femoral neck fracture
artificial femoral head replacement
hip
limbs length discrepancy
complications
