【摘要】 [目的]比较微创SuperPATH入路全髋置换术与空心钉内固定术治疗老年股骨颈骨折的临床效果。[方法]2012年11月～2018年12月收治的老年股骨颈骨折患者99例,按手术方式,50例采用微创SuperPATH入路全髋置换术治疗,另外49例采用空心钉内固定治疗,对比两组患者的临床效果。[结果]两组手术均顺利完成,无重大并发症,置换组失血量多于内固定组,手术时间长于内固定组,但其下地行走时间显著早于内固定组,住院时间短于内固定组(P<0.05)。随访4～12个月,平均(9.63±1.24)个月,末次随访时,置换组患者在髋关节活动度、Harris评分方面明显优于内固定组,差异有统计学意义(P<0.05)。置换组患者的临床结果总有效率为92.00%,内固定组的总有效率为81.63%。患者满意度置换组达到了96.00%,内固定组仅为65.31%,差异均存在统计学意义(P<0.05)。[结论]微创SuperPATH入路人工全髋置换术治疗老年股骨颈骨折明显优于空心钉内固定术,具有并发症少、临床效果好、患者的满意度高的优点。更多还原

【Abstract】 [Objective] To compare the clinical outcomes of femoral head replacement through SuperPATH versus internal fixation with cannulated screws for femoral neck fractures in elderly. [Method] From November 2012 to December 2018, a total of 99 elderly patients received surgical treatment for femoral neck fractures in our hospital. In term of operation performed, 50 patients underwent femoral head replacement through the minimally invasive SuperPATH, while the other 49 patients had the fractures fixed with cannulated screws. The clinical outcomes were compared between the two groups. [Results] The patients in both groups had operation performed smoothly without serious complications. Although the replacement group had significantly more intraoperative blood loss, and consumed significantly longer operation time than the fixation group(P<0.05), the former returned to ambulation significantly earlier, associated with significantly less hospital stay than the latter(P<0.05). The patients were followed up for 4～12 months with an average of(9.63±1.24) months. At the latest follow up, the replacement group proved significantly superior to the fixation group regarding to the hip range of motion(ROM) and Harris scores, which were statistically significant(P<0.05). The replacement group was marked clinical efficiency of 92.00% and patient’s satisfaction of 96.00%,whereas the fixation group was of 81.63% and 65.31% respectively, which were statistically significant(P<0.05). [Conclusion]The femoral head replacement through minimally invasive SuperPATH with benefits of reducing complication, enhancing rehabilitation and upgrading patient’s satisfaction does be superior to the internal fixation with cannulated screws for femoral head fractures in the elderly.更多还原