全髋关节置换与内固定治疗老年移位型股骨颈骨折的远期疗效及费用比较

被引:32
作者
周锦春
陈哲峰
宋黄鹤
王青
刘锋
范卫民
机构
[1] 南京医科大学第一附属医院骨科
关键词
股骨颈骨折; 关节成形术, 置换, 髋; 骨折固定术, 内; 老年人;
D O I
暂无
中图分类号
R687.3 [骨骼手术]; R197.32 [组织与管理];
学科分类号
100220 [骨科学]; 100404 [儿少卫生与妇幼保健学];
摘要
目的比较全髋关节置换与内固定治疗老年移位型股骨颈骨折的远期疗效及治疗费用。方法回顾性分析2000年1月至2004年1月收治的98例老年移位型股骨颈骨折患者资料, 男44例, 女54例;年龄为60~69岁, 平均(65.5±3.1)岁;骨折Garden分型:Ⅲ型42例, Ⅳ型56例。根据内固定手术方式不同分为关节置换组(49例)与内固定组(49例), 记录并比较两组患者的术后并发症发生率、再手术率、末次随访时髋关节Harris评分及治疗费用等。结果 98例患者术后获10~13年(平均11.0年)随访。关节置换组患者的术后并发症发生率[8.2% (4/49)]及再手术率[8.2% (4/49)]均低于内固定组患者[28.6% (14/49)、28.6% (14/49)], 末次随访时髋关节Harris评分[(94.9±3.1)分]高于内固定组患者[(88.0±3.2)分], 再次手术费用[(2 367±891)元]和求医问药费用[(382±98)元]显著低于内固定组患者[(16 089±2 567)元、(6 603±1 025)元], 但初次手术费用[(35 124±5 789)元]和治疗总费用[(38 785±3 981)元]高于内固定组患者[(16 546±3 892)、(36 654±3 768)元], 以上项目比较差异均有统计学意义(P<0.05)。结论与内固定术相比, 髋关节置换术治疗老年移位型股骨颈骨折的远期临床疗效更好, 治疗总费用仅略高, 是一种更优的选择。
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