中国组织工程研究2017，Vol.21Issue(15)：2320-2324,5.DOI:10.3969/j.issn.2095-4344.2017.15.005
两种股骨假体半髋置换治疗股骨颈骨折的比较
Comparison of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty
李国威 1郭远清 1陈涛 1张奎渤 1张大卫 1于兵 1张荣凯1
作者信息
- 1. 中山大学附属第五医院脊柱外科,广东省珠海市 519001
- 折叠
摘要
Abstract
BACKGROUND: Studies have shown that hemiarthroplasty is suitable for single femoral head diseases with normal acetabulum. But indications for choosing bone cement or biological fixation types, short- and long-term efficacy as well as the complications have not yet reached agreement.OBJECTIVE: To discuss the efficacy of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty,and the application of three-dimensional CT reconstruction in displaced fractures.METHODS: Clinical data of 73 cases of femoral head fractures undergoing hemiarthroplasty were analyzed retrospectively, and divided into bone cement and biological groups. All patients were followed up for 1.5 years, and the operation indexes, hospitalization time and hip joint function were compared; the consistent degree with intraoperative findings was compared through hip three-dimensional CT and X-ray examination simultaneously.RESULTS AND CONCLUSION: (1) There was no significant difference in the effective rate between groups (P > 0.05).(2) The operation time in the biological group was significantly shorter than that in the bone cement group (P < 0.05); the intraoperative blood loss and hospitalization time in the bone cement group were significantly less than those in the biological group (P < 0.05). (3) The Harris scores in the bone cement group were significantly higher than those in the biological group at 1 month after replacement (P < 0.05); the Harris scores in the biological group were significantly higher than those in the bone cement group at 18 months after replacement (P < 0.05); while there were no significant differences between two groups at 3, 6 and 12 months after replacement. (4) The hip three-dimensional reconstruction and X-ray examination showed no error compared with the intraoperative findings, reaching 100%. (5) Our findings suggest that age, disease history and bone quality should be considered when choosing an appropriate type of hemiarthroplasty for the patients with femoral neck fractures, and bone cement prosthesis is suitable for the elder patients with severe osteoporosis; while those with good bone quality should receive biological prosthesis. Besides, the diagnosis accuracy of three-dimensional reconstruction is superior to X-ray examination, which is conductive to fully understand displaced fractures.关键词
骨科植入物/人工假体/半髋置换/骨水泥/非骨水泥/股骨颈骨折/三维重建分类
医药卫生引用本文复制引用
李国威,郭远清,陈涛,张奎渤,张大卫,于兵,张荣凯..两种股骨假体半髋置换治疗股骨颈骨折的比较[J].中国组织工程研究,2017,21(15):2320-2324,5.
