老年移位性股骨颈骨折患者双极半关节置换术与全髋关节置换术的功能效果比较

Ali Abdalnabi Alwan Al-Tamimi, Omer Ali Rafiq Barawi, Rawand Mohammed Ali Kareem
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引用次数: 0

摘要

目的:本研究的目的是比较全髋关节置换术和双极半关节置换术治疗老年患者损伤后3个月和1年后移位的股骨颈骨折的功能结果。方法:前瞻性研究纳入43例年龄大于60岁的患者,其中24例采用全髋关节置换术,19例采用双相半髋关节置换术。这些患者术后随访1年,分别为3个月和12个月,用harris髋关节评分比较功能结果。结果:全髋关节置换术组的手术时间(98.54 min)明显高于双极半关节置换术组(62.63 min),术中出血量(322.5 ml)也明显高于双极半关节置换术组(178.42 ml)。在并发症方面,两组无差异;然而,双相半关节置换术患者的死亡率较高。全髋关节置换术组的平均harris髋关节评分、疼痛和运动在三个月和一年的随访后明显改善。两组患者术后3个月功能基本相同,但全髋关节置换术组随访1年后功能明显改善(p值<0.5)。结论:老年活动期股骨颈骨折患者全髋关节置换术在随访3个月和1年后的功能效果优于双相半关节置换术。双极半关节置换术可能适用于预期寿命较短且有多种合并症的老年非活动患者
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Comparison of functional outcome between Bipolar Hemiarthroplasty and total Hip Arthroplasty for displaced femoral neck fractures in elderly patients
Objectives: The intention of this study to compare functional outcomes between Total Hip Arthroplasty and Bipolar Hemi Arthroplasty for displaced femoral neck fracture after 3 months and 1 year from injury in elderly patients. Methods: Prospectively 43 patients were enrolled in this study, ages more than 60, twenty-four of them managed by Total Hip Arthroplasty, and 19 were managed by Bipolar Hemi Arthroplasty. These patients were followed up postoperatively for one year, at (3 and 12 months), to compare functional outcomes using Haris Hip Score. Results: Duration of operation was significantly higher in Total Hip Arthroplasty (98.54 min) versus (62.63 min) in the Bipolar Hemi Arthroplasty group, and intra-operative blood loss also considerably higher in Total Hip Arthroplasty (322.5 ml) than Bipolar Hemi Arthroplasty (178.42 ml). Regarding complications, there is no difference between the two groups; however, the incidence of mortality higher in the Bipolar Hemi Arthroplasty population. Average Haris Hip Score, pain and the motion were significantly better after three months and one-year follow-up in the Total Hip Arthroplasty group. The function was nearly the same at both groups after three months but after one-year of follow-up function significantly better (p-value <0.5) in the Total Hip Arthroplasty patients.Conclusion: Total Hip Arthroplasty provides better functional outcomes after three months and one year of follow-up than Bipolar Hemi Arthroplasty when used to manage femoral neck fracture for active old age patients. Bipolar Hemi Arthroplasty may be suitable for older inactive patients with narrow life expectancy with multiple comorbiditie
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