Delamarter R, Moreland J R
Clin Orthop Relat Res. 1987 May(218):68-74.
Between 1973 and 1983, 27 patients with acute femoral neck fractures were treated at the UCLA Medical Center with total hip arthroplasty. These cases were selected on the basis of age, high activity level, and degenerative changes in the acetabular cartilage. The average age was 72 years. There were 19 women and eight men. The average follow-up period was 3.8 years with a range of one to ten years. Methods used included analysis of clinical data, roentgenograms, final pain ratings, walking ratings, and activity levels using the UCLA rating system. Pain relief and overall functional results were better than that of most series of acute femoral neck fractures treated with hemiarthroplasty and similar to that of total hip arthroplasty series. The complication rate was slightly less than both authors' elective total hip series, and considerably less than most hemiarthroplasty series. Complications included a superficial wound infection, a urinary tract infection, and a perforated colon diverticulum. Four patients died within one year from causes unrelated to the hip arthroplasty. There were no deep infections, dislocations, or reoperations. Total hip arthroplasty in selective cases of acute femoral neck fractures can give more consistent pain relief and better functional results than hemiarthroplasty, without an increase in complications.
1973年至1983年间，加州大学洛杉矶分校医学中心对27例急性股骨颈骨折患者进行了全髋关节置换术治疗。这些病例是根据年龄、高活动水平和髋臼软骨退变情况选择的。平均年龄为72岁。其中女性19例，男性8例。平均随访期为3.8年，范围为1至10年。使用的方法包括分析临床数据、X线片、最终疼痛评分、步行评分以及使用加州大学洛杉矶分校评分系统评估活动水平。疼痛缓解情况和整体功能结果优于大多数采用半髋关节置换术治疗的急性股骨颈骨折系列，与全髋关节置换术系列相似。并发症发生率略低于两位作者的择期全髋关节置换术系列，且远低于大多数半髋关节置换术系列。并发症包括1例表浅伤口感染、1例尿路感染和1例结肠憩室穿孔。4例患者在1年内死于与髋关节置换术无关的原因。未发生深部感染、脱位或再次手术。在选择性急性股骨颈骨折病例中，全髋关节置换术比半髋关节置换术能提供更持续的疼痛缓解和更好的功能结果，且不会增加并发症。
