改良Hardinge入路骨水泥型假体人工股骨头置换术临床疗效分析

摘要
图/表
参考文献(27)
相关文章 (9)

全文: PDF (789 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的分析改良Hardinge 入路骨水泥型假体人工股骨头置换术的临床疗效。方法回顾性分析2016年1月至2019年1月因股骨颈骨折在扬州市江都人民医院骨科行人工股骨头置换的108 例老年患者的临床资料，按照手术方式分为观察组（45 例）与对照组（63 例）。观察组患者采用改良Hardinge 入路骨水泥假体，对照组患者采用后外侧入路非骨水泥假体，比较两组患者的切口长度、手术时间、术前及术后血红蛋白量（Hb）、输血率、术后并发症及Harris 髋关节功能评分。结果观察组切口长度短于对照组，手术时间长于对照组，差异有统计学意义（P＜0.05）。术后1 个月，观察组Harris 髋关节功能评分高于对照组，差异有统计学意义（P＜0.05）。两组的手术前后Hb、输血率、各并发症发生率、术后6 个月Harris 髋关节功能评分比较，差异无统计学意义（P＞0.05）。结论改良Hardinge 入路骨水泥型假体人工股骨头置换术具有手术切口小，髋关节功能早期改善快等优点，能够为老年股骨颈骨折的治疗提供新的选择。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张敏
	孙钰
	李立
	陈刚
	朱友森

关键词 ：老年股骨颈骨折, 人工股骨头置换术, 改良Hardinge 入路, 骨水泥

Abstract：Objective To analyze the clinical efficacy of modified Hardinge approach cemented artificial femoral head replacement. Methods A retrospective analysis of the clinical data of 108 elderly patients who underwent artificial femoral head replacement in the Department of Orthopedics, Jiangdu People's Hospital of Yangzhou City from January 2016 to January 2019 due to femoral neck fractures, and divided them into observation group (45 cases) and control group according to the operation method Group (63 cases). The observation group used the modified Hardinge approach bone cement prosthesis, and the control group used the posterolateral approach non-cemented prosthesis. The incision length, operation time, preoperative and postoperative hemoglobin (Hb) and blood transfusion were compared between the two groups. Rate, postoperative complications and Harris hip function score. Results The incision length of the observation group was shorter than that of the control group, and the operation time was longer than that of the control group, the differences were statistically significant (P＜0.05). One month after the operation, the Harris hip function score of the observation group was higher than that of the control group, and the difference was statistically significant(P＜0.05). There were no significant differences in Hb, blood transfusion rate, complication rate, Harris hip function score at 6 months after operation between the two groups (P ＞0.05). Conclusion The modified Hardinge approach cemented femoral head replacement has the advantages of smaller surgical incision and rapid early improvement of hip function. It can provide a new choice for the treatment of femoral neck fracture in the elderly.

Key words： Elderly femoral neck fracture Artificial femoral head replacement Modified Hardinge approach Cement

通讯作者: 孙钰（1980-），男，山东临沂人，博士，副主任医师，研究方向：关节外科疾病的诊治。

引用本文:

张敏；孙钰；李立；陈刚；朱友森. 改良Hardinge入路骨水泥型假体人工股骨头置换术临床疗效分析[J]. 中国当代医药, 2022, 29(4): 24-28.
ZHANG Min；SUN Yu；LI Li；CHEN Gang；ZHU Yousen. Analysis of clinical efficacy of modified Hardinge approach cemented artificial femoral head replacement. 中国当代医药, 2022, 29(4): 24-28.

链接本文:

https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I4/24

[3]	王蒙，唐华羽，王福成.股骨假体周围骨折治疗现状及研究进展[J].中国老年学杂志，2020，1（40）：219-222.
[6]	陈善斌，刘智.老年股骨颈骨折手术治疗中骨水泥型假体和生物型假体的选择[J].中华创伤骨科杂志，2016，18（5）：451-455.
[1]	De Vries EN，Gardenbroek TJ，Ammerlaan H，et al.The optimal approach in hip hemiarthroplasty：a cohort of 1009 patients[J].Eur J Orthop Surg Traumatol：orthopedie traumatologie，2020，30（4）：569-573.
[2]	Okike K，Chan PH，Prentice HA，et al.Association Between Uncemented vs Cemented Hemiarthroplasty and Revision Surgery Among Patients With Hip Fracture[J].JAMA，2020，323（11）：1077-1084.
[4]	Moerman S，Mathijssen NMC，Tuinebreijer WE，et al.Hemiarthroplasty and total hip arthroplasty in 30，830 patients with hip fractures：data from the Dutch Arthroplasty Register on revision and risk factors for revision[J].Acta Orthop，2018，89（5）：509-514.
[5]	Lin FF，Chen YF，Chen B，et al.Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures：A meta-analysis of randomized controlled trails[J].Medicine（Baltimore），2019，98（8）：e14634.
[7]	Li N，Zhong L，Wang C，et al.Cemented versus uncemented h emi-arthroplasty for femoral neck fractures in elderly patients[J].Medicine，2020，99（8）：e19039.
[8]	Doyle DJ，Goyal A，Bansal P，et al.American Society of Anesthesiologists Classification[M].StatPearls.Treasure Island（FL）；StatPearls Publishing Copyright 2021，StatPearls Publishing LLC.2021.
[9]	Masionis P，Uvarovas V，Mazarevicius G，et al.The reliability of a Garden，AO and simple Ⅱstage classifications for intracapsular hip fractures[J].Orthop Traumatol Surg Res，2019，105（1）：29-33.
[10]	Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures：treatment by mold arthroplasty.An end-result study using a new method of result evaluation[J].J Bone Joint Surg Am，1969，51（4）：737-755.
[11]	张道俭，朱天岳，柴卫兵，等.全髋关节置换术中解剖柄股骨假体周围骨折的影像学分析[J].中华医学杂志，2013，9（93）：690-692.
[12]	汪飞，邱麟，佘国荣，等.人工髋关节置换术后并发症影像学表现[J].中国医学影像技术，2015，31（7）：1095-1099.
[13]	Okike K，Chan PH，Prentice HA，et al.Association Between Uncemented vs Cemented Hemiarthroplasty and Revision Surgery Among Patients With Hip Fracture[J].JAMA，2020，323（11）：1077-1084.
[14]	Jay RH，Hipps D.Hip fracture-great steps forward but we still need better evidence.A commentary on NICE CG124 and QS16 on fractured neck of femur[J].Age and Ageing，2018，47（5）：630-632.
[15]	Kristensen TB，Dybvik E，Kristoffersen M，et al.Cemented or Uncemented Hemiarthroplasty for Femoral Neck Fracture?Data from the Norwegian Hip Fracture Register[J].Clin Orthop Relat Res，2020，478（1）：90-100.
[16]	Jn L，Sw K，Bh VD，et al.Comparison of cementless versus cemented stem survival：an analysis of 2934 patients with bilateral hip arthroplasties in the national joint registry of england and wales[J].Orthopaedic Proceedings，2019，101-B（SUPP_6）：20.
[17]	Hines CB.Understanding Bone Cement Implantation Syndrome[J].AANA J，2018，86（6）：433-441.
[18]	Tan KG，Whitehouse SL，Crawford RW.On-Table and Short-Term Mortality：A Single-Institution Experience with Cementing All Hip Arthroplasties for Neck of Femur Fractures[J].J Arthroplasty，2020，35（4）：1095-1100.
[19]	Ekman E，Laaksonen I，Isotalo K，et al.Cementing does not increase the immediate postoperative risk of death after total hip arthroplasty or hemiarthroplasty：a hospital-based study of 10，677 patients[J].Acta Orthop，2019，90（3）：270-274.
[22]	高山，周方，吕扬，等.新型多孔聚甲基丙烯酸甲酯骨水泥的制备及性能分析[J].中国组织工程研究，2019，2（23）：204-210.
[20]	Emara AK，Ng M，Krebs VE，et al.Femoral Stem Cementation in Hip Arthroplasty：The Know-How of a "Lost" Art[J].Curr Rev Musculoskelet Med，2021，14（1）：47-59.
[21]	Ekman E，Palompagenumber_ebook=34,pagenumber_book=28i A，Laaksonen I，et al.Early postoperative mortality similar between cemented and uncemented hip arthroplasty：a register study based on Finnish national data[J].Acta Orthop，2019，90（1）：6-10.
[23]	Barenius B，Inngul C，Alagic Z，et al.A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture：a four-year followup[J].Bone Joint J，2018，100-b（8）：1087-1093.
[24]	Lamb JN，Baetz J，Messer-Hannemann P，et al.A calcar collar is protective against early periprosthetic femoral fracture around cementless femoral components in primary total hip arthroplasty：a registry study with biomechanical validation[J].Bone Joint J，2019，101-b（7）：779-786.
[25]	Abdel MP，Watts CD，Houdek M T，et al.Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties：a 40-year experience[J].Bone Joint J，2016，98-b（4）：461-467.
[26]	Zhang Y，Yao Z，Shi P，et al.Morphological risk factors associated with dislocation after bipolar hemiarthroplasty of the hip in patients with femoral neck fractures-a nested case-control study[J].J Orthop Surg Res，2019，14（1）：395.
[27]	Sven pagenumber_ebook=34,pagenumber_book=28y S，Westberg M，Figved W，et al.Posterior versus lateral approach for hemiarthroplasty after femoral neck fracture：Early complications in a prospective cohort of 583 patients[J].Injury，2017，48（7）：1565-1569.