Baba Tomonori, Shitoto Katsuo, Kaneko Kazuo
Tomonori Baba, Kazuo Kaneko, Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
World J Orthop. 2013 Apr 18;4(2):85-9. doi: 10.5312/wjo.v4.i2.85.
To evaluate whether walking ability recovers early after bipolar hemiarthroplasty (BHA) using a direct anterior approach.
Between 2008 and 2010, 81 patients with femoral neck fracture underwent BHA using the direct anterior approach (DAA) or the posterior approach (PA). The mean observation period was 36 mo. The age, sex, body mass index (BMI), time from admission to surgery, length of hospitalization, outcome after discharge, walking ability, duration of surgery, blood loss and complications were compared.
There was no significant difference in the age, sex, BMI, time from admission to surgery, length of hospitalization, outcome after discharge, duration of surgery and blood loss between the two groups. Two weeks after the operation, assistance was not necessary for walking in the hospital in 65.0% of the patients in the DAA group and in 33.3% in the PA group (P < 0.05). As for complications, fracture of the femoral greater trochanter developed in 1 patient in the DAA group and calcar crack and dislocation in 1 patient each in the PA group.
DAA is an approach more useful for BHA for femoral neck fracture in elderly patients than total hip arthroplasty in terms of the early acquisition of walking ability.
评估采用直接前路行双极半髋关节置换术（BHA）后步行能力是否能早期恢复。
2008年至2010年期间，81例股骨颈骨折患者采用直接前路（DAA）或后路（PA）行BHA。平均观察期为36个月。比较两组患者的年龄、性别、体重指数（BMI）、入院至手术时间、住院时间、出院后结局、步行能力、手术时间、失血量及并发症情况。
两组患者在年龄、性别、BMI、入院至手术时间、住院时间、出院后结局、手术时间和失血量方面无显著差异。术后两周，DAA组65.0%的患者在医院内行走无需辅助，PA组为33.3%（P<0.05）。并发症方面，DAA组有1例患者发生股骨大转子骨折，PA组各有1例患者发生股骨距裂纹和脱位。
就早期获得步行能力而言，对于老年股骨颈骨折患者行BHA，DAA比全髋关节置换术更有用。
