全髋与半髋置换术治疗老年人股骨颈骨折疗效比较

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Abstract Objective To compare clinical efficacy and cost-effectiveness in treatment of femoral neck fracture with total hip arthroplasty(THA) and bipolar hemiarthroplasty(BHA) in elderly.Methods 169 patients over 70 years old with femoral neck fractures were treated with either THA or BHA.Comparison between THA and BHA groups were carried out on operation duration，incision size，blood loss，postoperative drainage，transfusion volume，average length of hospital stay，average cost，complication rate，hip function(Harris scores) and X-ray assessment.Results The patients were followed up for 2 years to 5.7 years，with an average follow-up period of 5.1 years.The operation duration，amounts of blood loss，postoperative drainage，blood transfusion，postoperative dislocation rate and average cost of THA group were greater than those of BHA group(P＜0.05，respectively).Differences of average length of hospitalization，incision size，postoperative Harris scores，incidence of complications and infection rates between the two groups were not significant(P＞0.05，respectively).In the patients over 75 years old，there were not significant differences on Harris scores 2 and 5 years post-operation and mortality between the two groups(P＞0.05，respectively).The Harris scores at 0.5 years post-operation of BHA group was higher than that of THA group(P＜0.05).Conclusion The clinical efficacy of BHA at mid-term was similar to that of THA in treatment of femoral neck fracture in elderly.However，BHA may be more suitable for patients who are frail and with complications because of it’s advantage in less surgical trauma and risks，quicker recovery and lower cost than THA.

Key words： femoral neck fracture total hip arthoplasty bipolar hemiarthroplasty elderly

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［1］胥少汀，葛宝丰，徐印坎.实用骨科学［M］.北京：人民军医出版社，2012：928.
［2］Blomfeldt R，Tornkvist H，Eriksson K，et al.A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients［J］.J Bone Joint Surg(Br)，2007，89(2)：160-165.
［3］Liu JM，Ning G，Chen JL.Osteoporotic fractures in Asia：risk factors and strategies for prevention［J］.J Bone Miner Metab，2007，25(1)：1-5.
［4］Raaymakers E.Fractures of the femoral neck.A review and personal statement［J］.Acta Chir Orthop Traumatol Cech，2006，73(1)：45.
［5］Brostr-m LA，Barrios C，Kronberg M，et al.Clinical features and walking ability in the early postoperative period after treatment of trochanteric hip fractures［J］.Ann Chir Gynaecol，1992，81(1)：66-71.
［6］Lu Yao GL，Keller RB，Littenberg B，et al.Outcomes after displaced fractures of the femoral neck.A meta-analysis of one hundred and six published reports［J］.J Bone Joint Surg，1994，76(1)：15-25.
［7］Barrack RL，Burnett RSJ.Preoperative planning for revision total hip arthroplasty［J］.J Bone Joint Surg，2005，87(12)：2800-2811.
［8］Tarasevicius S，Jermolajevas V，Tarasevicius R，et al.Total hip replacement for the treatment of femoral neck fractures.Long-term results［J］.Medicina(Kaunas)，2005，41(6)：465-469.
［9］Macaulay W，Nellans KW，Garvin KL，et al.Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures：winner of the Dorr Award［J］.J Arthroplasty，2008，23(6)：2-8.
［10］Keating J，Grant A，Masson M，et al.Randomized comparison of reduction and fixation，bipolar hemiarthroplasty，and total hip arthroplastyTreatment of displaced intracapsular hip fractures in healthy older patients［J］.J Bone Joint Surg，2006，88(2)：249-260.
［11］Baker R，Squires B，Gargan M，et al.Total hip arthroplasty and hemiarthroplasty in mobile，independent patients with a displaced intracapsular fracture of the femoral neck A randomized，controlled trial［J］.J Bone Joint Surg，2006，88(12)：2583-2589.
［12］Bhandari M，Devereaux P，Tornettaill P，et al.Operative management of displaced femoral neck fractures in elderly patientsan international survey［J］.J Bone Joint Surg，2005，87(9)：2122-2130.
［13］Blomfeldt R，T-mkvist H，Eriksson K，et al.A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients［J］.J Bone Joint Surg(Br)，2007，89(2)：160-165.
［14］牟永忠，陈天国，赵正旭，等.80岁以上高龄股骨颈骨折关节置换术手术安全性的研究［J］.骨与关节损伤杂志，2004，19(7)：451-453.
［15］胥德政，任百芳.全髋关节与单双极人工股骨头置换治疗老年股骨颈骨折的疗效比较［J］.中国骨与关节损伤杂志，2011，26(6)：522-523.
［16］Leonardsson O，K-rrholm J，A-kesson K，et al.Higher risk of reoperation for bipolar and uncemented hemiarthroplasty：23 509 procedures after femoral neck fractures from the swedish hip arthroplasty register，20052010［J］.Acta Orthop，2012，83(5)：459-466.
［17］刘剑伟，蒋卫平.全髋置换术与半髋置换术治疗股骨颈骨折的疗效对比［J］.实用骨科杂志，2013，19(8)：747-749.
［18］Lee BP，Berry DJ，Harmsen WS，et al.Total hip arthroplasty for the treatment of an acute fracture of the femoral neck.Long-term results［J］.J Bone Joint Surg，1998，80(1)：70-75.
［19］Slover J，Hoffman MV，Malchau H，et al.A cost-effectiveness analysis of the arthroplasty options for displaced femoral neck fractures in the active，healthy，elderly population［J］.J Arthroplasty，2009，24(6)：854-860.
［20］Petersen M，J-rgensen H，Hansen K，et al.Factors affecting postoperative mortality of patients with displaced femoral neck fracture［J］.Injury，2006，37(8)：705-711.
［21］王海洲，谢杰伟，许树柴，等.老年股骨颈骨折治疗效果评价［J］.南方医科大学学报，2008，28(7)：1279-1280.
［22］吴梅祥，白波，钱东阳，等.高龄老年股骨颈骨折人工全髋与半髋关节置换术的选择［J］.中华关节外科杂志(电子版)，2009，3(3)：315-319.
［23］Ravikumar KJ，Marsh G.Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur 13 year results of a prospective randomised study［J］.Injury，2000，31(10)：793-797.
［24］车彪，邵增务，杨述华，等.老年股骨颈骨折患者选择髋关节置换的若干认识［J］.中国骨与关节损伤杂志，2008，23(7)：567-568.

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