上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (12): 1554-.doi: 10.3969/j.issn.1674-8115.2012.12.007

• 专题报道（骨关节疾病） • 上一篇    下一篇

全髋关节置换术治疗老年陈旧性股骨颈骨折的体会

马春辉, 易诚青, 李 夏, 王 谦, 周晓凯, 曹 云   

  1. 上海交通大学附属第一人民医院骨科, 上海 200080
  • 出版日期:2012-12-28 发布日期:2012-12-31
  • 通讯作者: 曹 云, 电子信箱: caoyun3000@126.com。
  • 作者简介:马春辉（1980—）, 男, 主治医师, 硕士；电子信箱: jsnt-mch@yeah.net。

Treatment of old femoral neck fracture in the elderly with total hip arthroplasty

MA Chun-hui, YI Cheng-qing, LI Xia, WANG Qian, ZHOU Xiao-kai, CAO Yun   

  1. Department of Orthopaedics, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
  • Online:2012-12-28 Published:2012-12-31

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摘要：

目的 对全髋关节置换术治疗老年陈旧性股骨颈骨折的效果和安全性进行临床评价。方法 36例老年陈旧性股骨颈骨折患者，平均年龄81.2岁，平均骨折病史9.4个月，接受全髋关节置换术；回顾分析围手术期的并发症，评估术后的髋关节功能。结果 所有患者术后均恢复站立行走，患者髋关节Harris评分由术前的32.6±8.4提高到术后6个月的86.7±6.2，优良率达91.7%（33/36）。术后并发症包括肺部感染、尿路感染、术后意识障碍、水电解质紊乱和低蛋白性水肿；所有患者均安全度过围手术期。结论 全髋关节置换术是老年陈旧性股骨颈骨折的有效治疗手段，完善的术前评估和围手术期的及时处理是手术取得良好恢复效果的关键。

关键词: 全髋关节置换术, 股骨颈骨折, 治疗

Abstract:

Objective To investigate the effect and safety of total hip arthroplasty in the treatment of old femoral neck fracture in the elderly. Methods Thirty-six elderly patients with old femoral neck fracture were treated with total hip arthroplasty. The average age of patients was 81.2 years, and the mean disease duration of bone fracture was 9.4 months. The perioperative complications were retrospectively analysed, and the function of hip joint was evaluated after operation. Results The walking ability was recovered in all patients. The Harris hip score increased from 35.6±8.4 before operation to 86.7±6.2 six months after operation, with the overall excellent rate of 91.7% (33/36). Postoperative complications included lung infection, urinary tract infection, transient disturbance of consciousness, water electrolyte disorder and low protein edema. There was no perioperative death. Conclusion Total hip arthroplasty is an effective treatment for old femoral neck fracture in the elderly. Perfect preoperative and perioperative management are important for favorable outcomes.

Key words: total hip arthroplasty, femoral neck fracture, treatment