CAJ | 학술논문

目的：探讨髋关节置换术治疗髋部骨折内固定失败的临床效果。方法选择2008年1月~2012年1月在本院进行髋关节置换的29例髋部骨折内固定失败患者进行全髋关节(全髋置换组，n=17)或半髋关节置换术(半髋置换组，n=12)治疗，比较两组的手术时间、术中出血量、住院时间和卧床时间，两组术前、术后6个月的髋关节功能Harris评分和优良率。结果29例患者均顺利完成手术，术后未出现髋关节脱位、严重感染及下肢静脉血栓形成等严重并发症，术后假体位置良好，半髋置换组的手术时间短于全髋置换组、术中出血量少于全髋置换组(P<0.05)，两组的住院时间、卧床时间差异无统计学意义(P>0.05)；两组术后6个月的髋关节Harris评分及髋关节功能优良率均较术前明显提高(P<0.05)，术后组间比较差异无统计学意义(P>0.05)。结论髋关节置换术是治疗髋部骨折内固定失败的有效手段，手术方式及假体的选择应根据患者的具体情况确定。
목적：탐토관관절치환술치료관부골절내고정실패적림상효과。방법선택2008년1월~2012년1월재본원진행관관절치환적29례관부골절내고정실패환자진행전관관절(전관치환조，n=17)혹반관관절치환술(반관치환조，n=12)치료，비교량조적수술시간、술중출혈량、주원시간화와상시간，량조술전、술후6개월적관관절공능Harris평분화우량솔。결과29례환자균순리완성수술，술후미출현관관절탈위、엄중감염급하지정맥혈전형성등엄중병발증，술후가체위치량호，반관치환조적수술시간단우전관치환조、술중출혈량소우전관치환조(P<0.05)，량조적주원시간、와상시간차이무통계학의의(P>0.05)；량조술후6개월적관관절Harris평분급관관절공능우량솔균교술전명현제고(P<0.05)，술후조간비교차이무통계학의의(P>0.05)。결론관관절치환술시치료관부골절내고정실패적유효수단，수술방식급가체적선택응근거환자적구체정황학정。
Objective To investigate the clinical effect of hip joint replacement surgery treating hip fracture after failed internal fixation. Methods 29 patients with hip fracture after failed internal fixation given hip joint replacement in our hospital from January 2008 to January 2012 were selected and they were treated with total hip (total hip replacement group,n=17) or half hip joint replacement surgery (half hip joint replacement group,n=12) respectively,the operation time,intraoperative blood loss,hospitalization time and bed time and Harris score and good and excellent rate of hip joint function before surgery and after 6 months operation were compared between two groups. Results 29 patients were successfully completed the operation without serious complications of hip joint dislocation,severe infection and deep ve-nous thrombosis of lower extremity,postoperative prosthesis location was good,and the operation time of half hip joint replacement group was shorter than that of total hip replacement group,intraoperative blood loss of half hip joint re-placement group was fewer than that of total hip replacement group (P<0.05),and there were no statistical difference of hospital stay,bed time between two groups (P>0.05);Harris score and good and excellent rate of hip joint function after 6 months peration in two groups was significantly increased compared with bdfore surgery (P<0.05),and there was no statistica difference of above-mentioned indexes between two groups (P>0.05). Conclusion Hip joint replacement surgery is an effective approach in the treatment of hip fracture after failed internal fixation and selection of surgical methods and prosthesis should be chosen according to the specific circumstances of patients.