Citation: | ZHU Linsong, DAI Jun. Anterolateral approach versus posterolateral approach for hemiarthroplasty in the treatment of elderly patients with displaced femoral neck fracture[J]. Journal of Clinical Medicine in Practice, 2023, 27(21): 101-104. DOI: 10.7619/jcmp.20231930 |
To compare the clinical effect between anterolateral approach and posterolateral approach for hemiarthroplasty in the treatment of elderly patients with displaced femoral neck fracture.
A total of 96 elderly patients with femoral neck fracture were selected as research objects, and all of them were treated with hemiarthroplasty. According to the surgical approaches, there were 40 cases in the anterolateral approach group and 56 cases in the posterolateral approach group. The clinical efficacy was compared between the two groups.
The intraoperative blood loss, incision length, surgical time, postoperative bed-off activity time and postoperative hospital stay of patients in the anterolateral approach group were significantly better than those in the posterolateral approach group (P < 0.05); on the first and the second days after operation, the levels of C-reactive protein and serum creatine kinase in the anterolateral approach group were significantly lower than those in the posterolateral approach group (P < 0.05); at 12, 24 and 48 hours after surgery, the pain scores in the anterolateral approach group were significantly lower than those in the posterolateral approach group (P < 0.05); at hospital discharge and 4 weeks after surgery, the scores of Harris hip joint function in the anterolateral approach group were significantly higher than those in the posterolateral approach group (P < 0.05); the total incidence of postoperative complications in the anterolateral approach group was 5.0%, which was significantly lower than 19.6% in the posterolateral approach group (P < 0.05).
Compared with the posterolateral approach, the anterolateral approach for hemiarthroplasty can cause less trauma in the treatment of elderly patients with displaced femoral neck fracture, with a better efficacy and faster postoperative recovery.
[1] |
SHON W Y, PARK B Y, RAJSANKAR N R, et al. Total hip arthroplasty: past, present, and future. what has been achieved[J]. Hip Pelvis, 2019, 31(4): 179-189. doi: 10.5371/hp.2019.31.4.179
|
[2] |
任秋晓, 周甲彬, 谭淏文, 等. 直接前方与后外侧入路半髋关节置换术的早期疗效对比分析[J]. 天津医药, 2021, 49(9): 977-981. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYZ202109018.htm
|
[3] |
纪永志, 胡凯, 王利兵, 等. 小切口与传统后外侧入路全髋关节置换术的荟萃分析[J]. 中国矫形外科杂志, 2022, 30(8): 706-711. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS202208007.htm
|
[4] |
中华医学会骨科学分会创伤骨科学组, 中国医师协会骨科医师分会创伤专家工作委员会. 成人股骨颈骨折诊治指南[J]. 中华创伤骨科杂志, 2018, 20(11): 921-928.
|
[5] |
孙晔, 尤武林, 唐月琴, 等. 围术期加速康复外科模式对超高龄患者股骨颈骨折预后的效果[J]. 实用临床医药杂志, 2021, 25(24): 109-112. doi: 10.7619/jcmp.20212502
|
[6] |
衡红全, 杨渊, 胡雪峰, 等. 前外侧入路半髋关节置换术治疗高龄股骨颈骨折的早期临床疗效[J]. 中华骨科杂志, 2023, 43(4): 230-237. https://cdmd.cnki.com.cn/Article/CDMD-10285-1023000357.htm
|
[7] |
唐颂军, 刘嵘, 裴海涛. 术后早期系统康复治疗对高龄半髋置换术患者的影响[J]. 实用临床医药杂志, 2019, 23(7): 16-19. doi: 10.7619/jcmp.201907005
|
[8] |
何培亮, 陈思忆, 许华亮, 等. 老年股骨颈骨折两种入路半髋置换的荟萃分析[J]. 中国矫形外科杂志, 2021, 29(6): 516-520. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS202106010.htm
|
[9] |
AIT MOKHTAR M. Postero-posterolateral approach in total hip arthroplasty[J]. Int Orthop, 2020, 44(12): 2577-2585.
|
[10] |
黄存德, 韩国文, 张伟林. 微创直接前侧入路与后外侧入路半髋关节置换术治疗老年人股骨颈骨折的近期疗效分析[J]. 基层医学论坛, 2023, 27(10): 45-47. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT202310015.htm
|
[11] |
董瑞一, 朱仕文, 米萌. 老年股骨颈骨折治疗的策略[J]. 骨科临床与研究杂志, 2022, 7(3): 189-194. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC202203012.htm
|
[12] |
张彬, 张一, 佘荣峰, 等. 加速康复外科理念下应用股骨颈系统和空心螺钉治疗股骨颈骨折的近期疗效比较[J]. 骨科临床与研究杂志, 2022, 7(1): 15-21. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC202201004.htm
|
[13] |
PINCUS D, JENKINSON R, PATERSON M, et al. Association between surgical approach and major surgical complications in patients undergoing total hip arthroplasty[J]. JAMA, 2020, 323(11): 1070.
|