摘要
目的比较侧卧位后外侧入路与DAA入路行THA治疗股骨颈骨折的临床疗效及假体安放角度差异性。方法选取2015年10月至2019年11月就诊的股骨颈骨折行THA治疗的患者作为研究对象。采用随机数字表法随机分A组(侧卧位DAA入路)和B组(后外侧入路)。观察2组患者手术时间、手术切口长度、出血量、住院天数;髋臼假体的外展角和前倾,HHS评估髋关节功能,术后并发症如伤口感染、假体脱位、假体周围骨折骨折、深静脉血栓等。结果2组患者一般资料差异无统计学意义(P>0.05),B组的手术时间明显少于A组,差异有统计学意义(P<0.05);A组患者的手术切口长度明显小于B组,差异有统计学意义(P<0.05);A组患者的出血量明显少于B组,差异有统计学意义(P<0.05);A组患者住院天数明显少于B组,差异有统计学意义(P<0.05);2组患者的外展角度及前倾角度差异无统计学意义(P>0.05);术后3个月和术后6个月时A组患者HHS评分明显高于B组,差异有统计学意义(P<0.05);末次随访时2组患者的HHS评分差异无统计学意义(P>0.05)。患者患者术后均未发生明显并发症。结论在股骨颈骨折行THA治疗的患者中,与直接外侧入路相比,DAA入路行THA治疗股骨骨折手术切口小,术中出血少,住院时间短,假体安放角度较以后外侧无明显差异,术后早期髋关节功能明显优于后外侧入路。
Objective To compare the clinical efficacy and the differences of the prosthesis placement angle of total hip arthroplasty(THA)in treatment of femoral neck fracture between lateral position posterolateral approach and direct anterior approach(DAA)approach.Methods The patients with femoral neck fracture who were treated by THA in our hospital from October 2015 to November 2019 were enrolled in the study,who were randomly divided into group A(lateral position DAA approach)and group B(posterolateral approach)according to random number table method.The operating time,the length of operative incision,bleeding volume,the length of hospital stay,the abduction angle and anteversion angle of acetabular prosthesis of pateints between the two groups were observed and compared.The hip joint function,postoperative complications such as wound infection,prosthesis dislocation,prosthesis periphery bone fracture and deep venous thrombosis were evaluated by HHS.Results There were no significant difference in general data between the two groups(P>0.05).The operation time,surgical incision length,the bleeding volume as well as the length of staying in hospital in group A were significantly less than those in group B(P<0.05).However there were no significant differences in the abduction angle and anteversion angle between the two groups(P>0.05).At 3m and 6m after surgery,the HHS scores in group A were significantly higher than those in group B(P<0.05).At the last follow-up,there were no significant differences in HHS scores between the two groups(P>0.05).In addition no obvious complications were found after operation in both groups.Conclusion As compared with the posterolateral approach,the DAA approach during THA in treatment of femoral neck fracture has the advantages of smaller incision,less intraoperative bleeding,shorter hospital stay,however,there is no significant difference in the prosthesis placement angle between the two approaches.Moreover the early postoperative hip joint function by DAA approach is superior o that by posterior lateral approach.
作者
才智
刘亮
马峰
黄海
祖述春
孙利峰
刘星明
CAI Zhi;LIU Liang;MA Feng(Department of Osteology,Seaport Hospital of Qinhuangdao City,Hebei,Qinhuangdao 066000,China)
出处
《河北医药》
CAS
2021年第12期1826-1829,共4页
Hebei Medical Journal
关键词
股骨颈骨折
外展角
前倾角
评分
后外侧入路
femoral neck fracture
abduction angle
anteversion angle
score
posterolateral approach
