【摘要】 [目的]对全髋人工关节和多枚AO加压空心螺钉内固定治疗老年伴有移位的股骨颈骨折术后进行的疗效和生活质量评价。[方法]1998年5月~2003年10月,对44例老年股骨颈骨折(GardenⅢ型26例、Ⅳ型18例)分别予以3枚空心加压螺钉内固定(21髋)和全髋人工关节治疗(23髋)。分别用Charn ley改良M erle d’Aub ign’e评分法评定手术侧髋关节的疼痛、活动度和运动情况。采用欧洲生活质量评分—EQ-5D评分体系评定病人的健康生活质量评分。[结果]40例获得随访,随访时间至少24个月,骨折内固定组的手术后并发症发生率为36.8%(7/19),而全髋关节置换组的手术并发症发生率为4.7%。手术后24周的全髋关节置换组的髋关节功能Charn ley评分和生活质量评分明显高于骨折内固定组。[结论]与骨折内固定相比,对于手术前健康状况良好的伴有移位的老年股骨颈骨折病人,初次全髋关节置换具有并发症发生率低、髋关节功能恢复好、健康生活质量好等优点。更多还原

【Abstract】 [Objective]To evaluate the results of displaced neck fractures with internal fixation(AO compress cannulated screws) and total hip replacement.[Method]Form 1998.5～2003.10,forty-four patients(mean age 75.2 years) who had an acute displaced femoral neck fracture were treated with internal fixation(21 hips) and total hip replacement(23 hips).The hip function,including the pain,movement and walking,was evaluated by Charnley Score(Charnley improved Merle d’ Aubigné score).The health-related quality of patients’ life was rated with use of the EQ-5D index.[Result]Forty patients were followed up at least twentyfour months.The ratio of complications in fixation group,defined as nonunion,osteonecrosis and peri-implant fracture,was 36.8%.The ratio of complications in total hip replacement group,defined as dislocation,periprosthetic fracture,or radiographic signs of loosening of the femoral or acetaular component,was 4.7%.There was significance different between two group(P<0.05).The EQ-5D index in fixation group was lower than that in total hip replacement group.[Conclusion]Compared with internal fixation,primary total hip replacement provides a better outcome for mentally competent elderly patients with a displaced femoral neck fracture.更多还原