不同手术方式治疗髋关节置换术后股骨假体周围骨折的 疗效及安全性对比

刘海滨 1 ，董哲 2

1.延安市富县人民医院骨外科，陕西 延安，727500；2.延安大学附属医院骨外科，陕西 延安，716000

浏览次数：86次 下载次数：284次

摘要：

 目的 探讨不同手术方式治疗髋关节置换术后股骨假体周围骨折的疗效及安全性对比。方法 随机将 42例髋关节置换术后股骨假体周围骨折患者分为观察组和对照组，各 21例。观察组采用锁定钢板内固定治疗，对照组采用结构植骨捆绑固定治疗。观察两组患者的临床疗效及并发症发生情况。结果 观察组较对照组手术时间及术后髋关节愈合时间短、术后髋关节开始活动时间早，术中出血量少（P<0.05）；观察组术后疼痛评分、功能评分、活动评分、畸形评分、Harris总评分均明显高于对照组（P<0.05）；观察组并发症总发生率略低于对照组（P＞0.05）。结论 锁定钢板内固定治疗髋关节置换术后股骨假体周围骨折患者疗效显著，术中出血量少，有助于患者髋关节功能的恢复，值得临床推广。

关键词： 假体周围骨折；锁定钢板内固定；髋关节置换术

中图分类号： R687.4文献标志码：A文章编号：2096-1413(2018)09-0066-02

Comparison of the efficacy and safety of different surgical methods in the treatment of
femoral prosthesis fractures after hip arthroplasty
 

LIU Hai-bin 1 ,DONG Zhe 2*
(1.Orthopedics Department,the People's Hospital of Fu County,Yan'an 727500 ； 2.Orthope dics Department,
Yan'an University Affiliated Hospital,Yan'an 716000,China)



ABSTRACT: Objective To investigate the efficacy and safety of different surgical methods in the treatment of femoral prosthesis fractures after hip arthroplasty. Methods Forty-two patients with periprosthetic femoral fractures after hip arthroplasty were randomly divided into observation group and control group,with 21 cases in each group. The observation group were treated with locking plate internal fixation, and the control group were treated with structural bone grafting and fixation. The clinical efficacy and complications of the two groups were observed.Results The operation time and postoperative hip joint healing time in the observation group were shorter than those in the control group,post operative hip joint mobilization time was earlier,and the amount of intraoperative bleeding was less (P<0.05).The scores of pain,function,activity,deformityand thetotalHarrisscorein theobservation group weresignificantlyhigherthan thosein the control group (P<0.05);and the total incidence of complications in the observation group was slightly lower than that in the control group (P＞0.05).Conclusion Locking plate internal fixation in the treatment of hip pros the sisafter hip arthroplasty is significantly effective.The intra operative bleeding is less and it is helpful to the recovery of hip function.It is worthy of clinical promotion.
KEYWORDS: peripheral fracture of prosthesis; locking plate internalfixation; hip arthroplasty
 

参考文献：
[1] 顾邵,熊鹰.髋关节置换术后股骨假体周围骨折的治疗进展 [J]. 中外医疗,2015,27(14):195-196.
[2] 朱月新,张海涛,牛志勇,等.髋关节置换术后股骨假体周围骨折的病因分析及疗效探讨 [J]. 实用临床医药杂志 ,2016,20(23):164-166.
[3] 陈骁,金毅,程旭光,等.人工髋关节置换术后股骨假体周围骨折治疗 [J]. 中华实用诊断与治疗杂志 ,2015,29(12):1218-1219.
[4] 马界明,髋关节置换术后股骨假体周围骨折的手术治疗效果研究[J]. 当代医学 ,2017,23(7):53-54.
[5] 熊建,芦浩,付中国,等.髋关节置换术后股骨假体周围骨折的治疗进展 [J].现代实用医学 ,2015,27(2):137-139.
[6] 杨峰,唐淼.人工髋关节置换术后股骨假体周围骨折的治疗 [J]. 华夏医学 ,2015,28(5):48-50.
[7] 阳春华,王万春.髋关节置换术并发股骨假体周围骨折的治疗 [J].湖南师范大学学报:医学版 ,2010,7(4):48-49.