兩種股骨假體半髖置換治療股骨頸骨折的比較
發(fā)布時間：2019-03-30 18:40
【摘要】：背景:研究認為單純股骨頭疾病而髖臼側尚可的患者適合半髖置換,關于采用骨水泥型和非骨水泥型(即生物型)固定方式的適應證選擇及近期和遠期固定效果、并發(fā)癥等差異的報道出入較大。目的:對比分析兩種股骨假體半髖置換修復股骨頸骨折的效果及CT三維重建在移位性骨折中的應用。方法:回顧性分析73例股骨頸骨折全部行人工股骨頭置換患者資料,分骨水泥假體組和非骨水泥假體組。并隨訪1.5年,比較各項手術指標、住院時間、髖關節(jié)功能,通過同時檢查髖關節(jié)X射線片及三維CT,比較與術中所見的符合程度。結果與結論:(1)兩組患者有效率差異無顯著性意義(P0.05);(2)非骨水泥組手術時間少于骨水泥組(P0.05);置換中出血量骨、住院天數(shù)水泥組少于非骨水泥組且有統(tǒng)計學差異(P0.05);(3)置換后1個月骨水泥組關節(jié)Harris評分高于非骨水泥組(P0.05);置換后18個月非骨水泥組關節(jié)Harris評分高于骨水泥組(P0.05);置換后3,6,12個月兩組評分無明顯差異;(4)2組患者三維重建和術中所見無誤差,符合率達100%;(5)結果提示,應綜合考慮股骨頸骨折患者年齡、基礎疾病、骨條件選擇相應類型半髖置換,對于高齡且嚴重骨質疏松嚴重能接受手術的患者,建議選擇骨水泥型假體;對骨量條件良好者優(yōu)先考慮非骨水泥型;CT三維重建對移位型骨折診斷準確率及全面認識優(yōu)于X射線片。
[Abstract]:Background: it is considered that the patients with simple femoral head disease but the acetabular side are suitable for hemi-hip replacement. The choice of indications and the short-term and long-term fixation effects of cement-type and non-cement-type (i.e. biological) fixation methods are considered to be suitable for the patients with simple femoral head disease. Reports of complications vary widely. Objective: to compare and analyze the effect of half hip replacement with two kinds of femoral prosthesis in the treatment of femoral neck fracture and the application of CT three-dimensional reconstruction in transposition fracture. Methods: the data of 73 patients with femoral neck fracture underwent artificial femoral head replacement were retrospectively analyzed, which were divided into two groups: bone cement prosthesis group and non-bone cement prosthesis group. Follow-up of 1.5 years was performed to compare the operative parameters, hospital stay, hip joint function. The X-ray and three-dimensional CT, of hip joint were examined simultaneously and compared with the degree of coincidence observed during the operation. Results & conclusion: (1) there was no significant difference in the effective rate between the two groups (P0.05); (2). The operation time in the non cement group was shorter than that in the cement group (P0.05). The time of hospitalization in cement group was less than that in non-cement group and there was statistical difference (P0.05); (3). The score of joint Harris in cement group was higher than that in non-cement group 1 month after replacement (P0.05). The Harris score of the non-bone cement group was higher than that of the cement group at 18 months after replacement (P0.05); there was no significant difference between the two groups at 3,6,12 months after replacement; (4) there was no error between the two groups in 3D reconstruction and intraoperative findings, and the coincidence rate was 100%. (5) the results suggest that the age, basic disease and bone condition of patients with femoral neck fracture should be considered, and the corresponding type of semi-hip replacement should be considered. For the elderly patients with severe osteoporosis and severe osteoporosis, it is suggested that the bone cement prosthesis should be chosen. Non-cement type was preferred for those with good bone mass, and CT 3D reconstruction was superior to X-ray film in the diagnosis accuracy and overall recognition of transposed fracture.
【作者單位】： 中山大學附屬第五醫(yī)院脊柱外科;
【分類號】：R687.3
[Abstract]:Background: it is considered that the patients with simple femoral head disease but the acetabular side are suitable for hemi-hip replacement. The choice of indications and the short-term and long-term fixation effects of cement-type and non-cement-type (i.e. biological) fixation methods are considered to be suitable for the patients with simple femoral head disease. Reports of complications vary widely. Objective: to compare and analyze the effect of half hip replacement with two kinds of femoral prosthesis in the treatment of femoral neck fracture and the application of CT three-dimensional reconstruction in transposition fracture. Methods: the data of 73 patients with femoral neck fracture underwent artificial femoral head replacement were retrospectively analyzed, which were divided into two groups: bone cement prosthesis group and non-bone cement prosthesis group. Follow-up of 1.5 years was performed to compare the operative parameters, hospital stay, hip joint function. The X-ray and three-dimensional CT, of hip joint were examined simultaneously and compared with the degree of coincidence observed during the operation. Results & conclusion: (1) there was no significant difference in the effective rate between the two groups (P0.05); (2). The operation time in the non cement group was shorter than that in the cement group (P0.05). The time of hospitalization in cement group was less than that in non-cement group and there was statistical difference (P0.05); (3). The score of joint Harris in cement group was higher than that in non-cement group 1 month after replacement (P0.05). The Harris score of the non-bone cement group was higher than that of the cement group at 18 months after replacement (P0.05); there was no significant difference between the two groups at 3,6,12 months after replacement; (4) there was no error between the two groups in 3D reconstruction and intraoperative findings, and the coincidence rate was 100%. (5) the results suggest that the age, basic disease and bone condition of patients with femoral neck fracture should be considered, and the corresponding type of semi-hip replacement should be considered. For the elderly patients with severe osteoporosis and severe osteoporosis, it is suggested that the bone cement prosthesis should be chosen. Non-cement type was preferred for those with good bone mass, and CT 3D reconstruction was superior to X-ray film in the diagnosis accuracy and overall recognition of transposed fracture.
【作者單位】： 中山大學附屬第五醫(yī)院脊柱外科;
【分類號】：R687.3
【參考文獻】
相關期刊論文 前9條
1 姜超;梅炯;;股骨頸骨折分型的研究歷史與展望[J];中國矯形外科雜志;2014年10期
2 夏鐵成;郝建學;王明昊;蘇e，
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