CAJ | 학술논문

对施行内固定或全髋关节置换术后的新鲜老年股骨颈骨折患者的临床随访，总结所取得的经验和教训。材料及方法：我们对1997年6月-2004年10月间施行内固定或全髋关节置换术的老年患者（65岁以上）进行随访，获得随访58例，其中A组24例行空心拉力螺钉固定；B组34例行人工全髋关节置换。对其手术后功能恢复情况平均随访时间3.8年。结果：34例全髋关节置换（T H A）患者术后优良率91.2%（22例）；24例内固定（I F）患者术后优良率62.5%；A组严重并发症中有7例为骨折不愈合、股骨头坏死2例。结论：对于老年股骨颈骨折的治疗，全髋关节置换是一种有效的治疗方式；如果能够有效降低较高的骨折不愈合率，多枚中空拉力螺钉内固定也是一种可行的选择。
대시행내고정혹전관관절치환술후적신선노년고골경골절환자적림상수방，총결소취득적경험화교훈。재료급방법：아문대1997년6월-2004년10월간시행내고정혹전관관절치환술적노년환자（65세이상）진행수방，획득수방58례，기중A조24례행공심랍력라정고정；B조34례행인공전관관절치환。대기수술후공능회복정황평균수방시간3.8년。결과：34례전관관절치환（T H A）환자술후우량솔91.2%（22례）；24례내고정（I F）환자술후우량솔62.5%；A조엄중병발증중유7례위골절불유합、고골두배사2례。결론：대우노년고골경골절적치료，전관관절치환시일충유효적치료방식；여과능구유효강저교고적골절불유합솔，다매중공랍력라정내고정야시일충가행적선택。
control ed trials performed postoperatively have shown that a primary total hip replacement is superior to internal fixation for the treatment of a femoral neck fracture in a relatively healthy, mental y competent, elderly patient. The primary aim of the present study was to evaluate the outcomes. METHODS: 58 patients who had an acute femoral neck fracture were randomly al ocated to be treated with total hip replacement or internal fixation. 24 cases (A group)were treated by IF,and 34 cases(B group) were treated by THR. RESULTS: At the 3.8 years fol ow-up evaluation, the rate of hip complications was 8.8% in the patients treated with total hip replacement and 37.5% in those treated with internal fixation .The hip function was significantly better and the decline in health-related quality of life was less pronounced in the arthroplasty group than it was in the fixation group CONCLUSIONS: Compared with internal fixation, primary total hip replacement provides a better outcome for mental y competent elderly patients with a femoral neck fracture. If we can decrease the rate of the un-union ,then internal fixation was also good method.