浙江医学2018，Vol.40Issue(10)：1054-1058,5.DOI:10.12056/j.issn.1006-2785.2018.40.10.2017-2200
直接前方入路髋关节置换术治疗老年股骨颈骨折合并帕金森病的短期疗效观察
Direct anterior approach for hip arthroplasty in treatment of femoral neck fracture in elderly patients with Parkinson's disease
摘要
Abstract
Objective To evaluate the application of direct anterior approach for hip arthroplasty in treatment of femoral neck fracture in elderly patients with Parkinson's disease (PD). Methods The clinical data of 38 elderly PD patients (Hoehn-Yahr stage IV) with femoral neck fractures undergoing total hip arthroplasty in our hospital from October 2013 to October 2015 were retrospectively analyzed. The patients were divided into anterior approach and posterior approach groups with 19 cased in each group. Direct anterior or posterior hip arthroplasty, including total hip arthroplasty and bipolar arthroplasty, were performed. The patients were followed up for one month. The incision length, intraoperative blood loss, operation time, postoperative complications and incidence of dislocation were compared between the two groups. The clinical results were evaluated using modified Harris scores, X-ray films before and after surgery. Results The incision in the anterior approach group was shorter than that in the posterior approach group (P＜0.05). There was no significant difference in intraoperative blood loss and operation time between two groups. Harris scores at 1 month after surgery were significantly higher in the anterior group (82.4 ±1.7) than that in the posterior group (80.1 ±1.4, P＜0.05). X-ray examination showed that the hip joint prosthesis was stabilized 1 month after surgery in the anterior group. The rate of complications in the anterior group was 5.26％, which was significantly lower than that 15.79％ in posterior group (P＜0.05). In the direct anterior approach, there was 1 case of sensory hypoesthesia of the lateral thigh skin caused by the traction injury of the lateral femoral cutaneous nerve. Conclusion Direct anterior approach hip replacement for treatment of femoral neck fracture in elderly patients with Parkinson's disease has a good therapeutic efficacy and can significantly reduce the postoperative complications, especially hip dislocation.关键词
直接前方入路/髋关节置换/帕金森病/老年股骨颈骨折Key words
Direct anterior approach/Hip Replacement/Parkinson's disease/Senile femoral neck fracture引用本文复制引用
孙启才,宋柏杉,茹选良,端木群立,乔松,王祥华,严世贵..直接前方入路髋关节置换术治疗老年股骨颈骨折合并帕金森病的短期疗效观察[J].浙江医学,2018,40(10):1054-1058,5.基金项目
浙江省医药卫生科技计划一般项目(2012KYB007,2014KYB010) （2012KYB007,2014KYB010）
浙江省中医药科技计划项目(2017ZB003) （2017ZB003）
