CAJ | 학술논문

目的：探讨老年人尤其高龄患者股骨颈骨折的内固定术与股骨头置换术间手术选择及疗效。方法回顾性分析2010年至2013年于我院创伤骨科住院手术治疗的74例老年股骨颈骨折患者，分别采用空心钉内固定26例及人工股骨头置换组48例，术后均得到随访，随访时间6～24个月（平均18个月），比较分析两组间手术时间、术中出血量、术后下地活动时间、术后并发症发生率及 Harris 评分的差别。结果两组间手术时间、术中出血量、术后下地活动时间、术后并发症发生率及 Harris 评分差别有统计学意义（P <0.05）。结论两种术后对治疗老年人股骨颈骨折均有显著的疗效，人工股骨头置换术整体优于空心钉内固定术，对治疗血运差、不稳定型骨折，高龄（>80岁）合并严重骨质疏松患者具有不可替代的疗效。临床中应根据患者个体情况差异，综合分析、选择手术方式。
목적：탐토노년인우기고령환자고골경골절적내고정술여고골두치환술간수술선택급료효。방법회고성분석2010년지2013년우아원창상골과주원수술치료적74례노년고골경골절환자，분별채용공심정내고정26례급인공고골두치환조48례，술후균득도수방，수방시간6～24개월（평균18개월），비교분석량조간수술시간、술중출혈량、술후하지활동시간、술후병발증발생솔급 Harris 평분적차별。결과량조간수술시간、술중출혈량、술후하지활동시간、술후병발증발생솔급 Harris 평분차별유통계학의의（P <0.05）。결론량충술후대치료노년인고골경골절균유현저적료효，인공고골두치환술정체우우공심정내고정술，대치료혈운차、불은정형골절，고령（>80세）합병엄중골질소송환자구유불가체대적료효。림상중응근거환자개체정황차이，종합분석、선택수술방식。
Objective to discuss the therapeutic choice and effect of different methods in the treatment of advanced olders,femoral neck fracture.Methods retospective analysis the 74 advanced aged patients with femoral neck fracture,26 of which were fixed with internal fixation with cannulated screws, 48 fixed with articial femoral head replacement.All of patients have a follow-up visit ,for 6 months to 24 months(mean 18 months).Results articial femoral head replacement have a difference of mean operation time,blood loss, bed stay duration and Harris score ,which is statistical significail(P <0.05), compared with internal fixation with cannulated screws. Conclusion Both two different methods have effect for femoral neck fracture. articial femoral head replacement wholely be better, especially in the treatment of fracture with poor blood supply,or be untable,or for advanced olders suffered from serious osteoporosis.different patients are appropriated for the different treatments of olders,femoral neck fracture.