[1]贾建波,禹宝庆,吴良浩,等.传统后路与微创 SuperPath入路的半髋置换治疗老年股骨颈骨折疗效比较[J].中华老年骨科与康复电子杂志,2017,(04):223-231.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
　Jia Jianbo,Yu Baoqing,Wu Lianghao,et al.Hip hemiarthroplasty for senile femoral neck fractures: minimally invasive SuperPath approach versus traditional posterior approach[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(04):223-231.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
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传统后路与微创 SuperPath入路的半髋置换治疗老年股骨颈骨折疗效比较()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年04期
页码:
223-231
栏目:
髋部骨折
出版日期:
2017-07-15

文章信息/Info

Title:
Hip hemiarthroplasty for senile femoral neck fractures: minimally invasive SuperPath approach versus traditional posterior approach
作者:
贾建波; 禹宝庆; 吴良浩; 支中正; 潘利智
201399 上海市浦东医院骨科
Author(s):
Jia Jianbo;  Yu Baoqing;  Wu Lianghao;  Zhi Zhongzheng; Pan Lizhi.
Department of Orthopaedics, Shanghai Pudong Hospital, Shanghai 201399, China
关键词:
股骨颈骨折;  关节成形术; 置换; 髋;  外科手术; 微创;  SuperPath入路
Keywords:
Femoral neck fractures;  Arthroplasty;  replacement;  hip;  Surgical procedures;  minimally invasive;  SuperPath approach
DOI:
10.3877/cma.j.issn.2096-0263.2017.04.006
文献标志码:
A
摘要:
目的 比较微创 SuperPath入路与传统后路人工股骨头置换治疗老年股骨颈骨折的近期临床疗效。方法 前瞻性收集 2015年 5月至 2016年 5月上海市浦东医院骨科收治的 64例老年股骨颈骨折患者，随机分为微创组（微创 SuperPath入路人工股骨头置换术）和传统组（传统后路人工股骨头置换）。随访并比较两组患者手术时间、术中出血量、手术切口长度、术后 48 h引流量、开始负重活动时间及并发症的发生情况，采用髋关节 Harris 评分评定患者术前、术后 1 w 及术后 6 个月的髋关节功能。结果 所有患者均获得满意随访，随访时间（8.3±2.1）个月。与传统组相比，微创组患者的手术切口长度较小（[ 7.1±0.6）VS（17.1±1.9）cm，t=28.816，P＜0.01]，术中出血量较少（[ 132±29）VS（156±28）ml，t=3.392， P＜0.01]，术后 48 h 引流量较少（[ 86±19）VS（177±18）ml，t=19.895，P＜0.01]，开始负重活动时间较短（[ 2.6±1.0）VS（5.5±1.6）d，t=8.841，P＜0.01），但手术时间较长（[ 56±7）VS（52±6）min，t=2.830，P＜0.01]。与术前相比，两组患者术后 1 w、6个月的 Harris评分均显著提高（F=8880.318，F=3702.211，P＜0.01），其中微创组术后 1 w Harris 评分（[ 80.2±2.6）分]高于传统组（[ 67.7±5.1）分]，差异具有统计学意义（F=5.266，P=0.026）。术后 2 w所有患者均顺利出院，期间均无深静脉血栓形成、坐骨神经损伤麻痹、术后关节感染等相关并发症发生，微创组有1例患者出现术后髋关节脱位。结论 与传统后路相比，SuperPath 入路的人工股骨头置换治疗老年股骨颈骨折可有效减少手术损伤、加快术后髋关节功能恢复。
Abstract:
Objective To compare the short- term clinical outcomes of minimally invasive Super Path and conventional posterior hip artificial femoral head replacement in the treatment of elderly femoral neck fractures. Methods A prospective study was performed in 64 cases of eligible femoral neck fractures from May 2015 to May 2016 in Shanghai Pudong Hospital. They were randomly divided into minimally invasive group(minimally invasive Super Path artificial femoral head replacement) and traditional group (traditional posterior artificial femoral head replacement). The operation time, intraoperative blood loss, length of incision, postoperative 48 h drainage, time to weight- bearing, complications were evaluated between two groups, Hip Harris score before and after 1 week and 6 months after operation were used as a indication of hip joint function. Results All patients were received an average of 8.3±2.1 months of followup. Length of surgical incision in minimally invasive group was significant shorter than that in traditional group (7.1 ± 0.6 cm VS 17.1 ± 1.9 cm，t=28.816, P<0.01), blood loss of minimally invasive group was significant lesser than traditional group (132±29 ml VS 156±28 ml, t=3.392, P<0.01), same as the time to weight bearing (2.6±1.0 d VS 5.5±1.6 d, t=8.841, P<0.01) and postoperative 48 h drainage (86±19 ml VS 177 ± 18 ml, t=19.895, P<0.01). However, the traditional group had shorter operation time than minimally invasive group (52 ± 6 min VS 56 ± 7 min, t=2.830, P<0.01). Harris score at 1 week and 6 months after operation were significantly improved in both groups compared with preoperative Harris score (F=8880.318, F=3702.211, P<0.01), The Harris scores at 1 week after operation of minimally invasive group (80.2±2.6) was significantly higher than the traditional group (67.7 ± 5.1) (F=5.266, P=0.026). All patients were discharged at 2 weeks after operation, no deep venous thrombosis, paralysis of sciatic nerve injury, joint infection and other complications occurred during hospitalisation except one hip dislocation in traditional group. Conclusions SuperPath approach for artificial femoral head replacement can effectively reduce surgical injury and accelerate hip function recovery in the treatment of senile femoral neck fractures compared with traditional posterior approach surgeries.

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备注/Memo

备注/Memo:
上海市医学重点专科项目（ZK2015B17）；上海市领军人才培养计划；上海市浦东医院“浦秀计划”（PX201601）
更新日期/Last Update: 2017-07-14