直接前入路髋关节置换治疗股骨颈骨折Total hip arthroplasty through direct anterior approach for femoral neck fractures
汲方圆;吴玉宝;郝鹏;田纪伟;
摘要(Abstract):
[目的]评价直接前入路行髋关节置换治疗股骨颈骨折的临床结果。[方法]回顾性分析2018年10月—2020年6月采用全髋关节置换术治疗的65例股骨颈骨折患者的临床资料。其中,27例采用直接前入路(direct anterior approach, DAA),38例采用前外侧入路(anterolateral approach, ALA)。比较两组围手术期、随访以及临床影像评估结果。[结果]两组患者均顺利完成手术,术中未出现血管、神经损伤及假体周围骨折等并发症。两组的手术时间、术中出血量、术后引流量及住院天数差异无统计学意义(P>0.05),但DAA组手术切口长度显著小于ALA组(P<0.05)。DAA组完全负重活动时间显著早于ALA组(P<0.05)。与术后1个月相比,末次随访时两组患者Harris评分和髋伸屈ROM均显著增加(P<0.05)。术后1个月,DAA组Harris评分和髋伸屈ROM方面均显著优于ALA组(P<0.05),但是末次随访时,两组间Harris评分和髋伸屈ROM的差异均无统计学意义(P>0.05)。末次随访时,两组患者股骨前倾角、髋臼外展角及双侧股骨长度差值差异无统计学意义(P>0.05)。[结论]与前外侧入路比较,直接前入路手术切口短,恢复完全负重活动早,早期髋关节功能恢复更好。
关键词(KeyWords): 股骨颈骨折;髋关节置换术;前外侧入路;直接前入路
基金项目(Foundation):
作者(Authors): 汲方圆;吴玉宝;郝鹏;田纪伟;
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