Department of Orthopaedics, Peterborough City Hospital, Peterborough and Stamford Hospital NHS Foundation Trust, Bretton Gate, Peterborough PE3 9GZ, England, United Kingdom.
Injury. 2019 Nov;50(11):2009-2013. doi: 10.1016/j.injury.2019.09.018. Epub 2019 Sep 10.
Controversy exists for the optimum method of surgical treatment for the 'fitter' elderly patient with a displaced intracapsular fracture. 105 patients were randomised to treatment with either a cemented polished tapered stem hemiarthroplasty or a cemented total hip arthroplasty (THR) with a cemented acetabular cup. All patients were followed up for a minimum of one year using a blinded assessment of functional outcome. Those patients treated with a THR had a tendency to a longer hospital stay and increased medical (12 versus 62) and surgical complications (4 versus 2) in comparison to those treated by hemiarthroplasty. Mean operative times (842 versus 52 min) and operative blood loss (335mls versus 244mls) were increased for THR. Final outcome measures of residual pain and regain of function were similar for both methods of treatment. We recommend that caution should be exercised regarding the increased promotion of THR for intracapsular hip fractures until further studies are completed.
对于“身体状况更好”的老年移位囊内骨折患者，手术治疗的最佳方法存在争议。105 名患者被随机分为骨水泥固定抛光锥形柄半髋关节置换组或骨水泥固定全髋关节置换（THR）加骨水泥固定髋臼杯组。所有患者均进行了至少 1 年的随访，采用盲法评估功能结果。与接受半髋关节置换的患者相比，接受 THR 治疗的患者住院时间更长，医疗费用（12 比 62）和手术并发症（4 比 2）更高。THR 的平均手术时间（842 比 52 分钟）和手术失血量（335 毫升比 244 毫升）增加。两种治疗方法的最终疼痛残留和功能恢复的测量结果相似。我们建议，在进一步的研究完成之前，应谨慎对待 THR 在囊内髋部骨折治疗中的过度推广。
