Jia Ying-Ao, Qiao Li-Na, Liu Zhi-Bin, Xue Liang, Bi Wei-Ming, Chen Meng-Fei, Kang Kai, Wang Fei
Department of Orthopaedics, Affiliated Hospital of Yan'an University, Yan'an, 716000, People's Republic of China.
Department of Pathology, Affiliated Hospital of Yan'an University, Yan'an, 716000, People's Republic of China.
J Multidiscip Healthc. 2025 Jun 12;18:3391-3401. doi: 10.2147/JMDH.S515576. eCollection 2025.
The study investigated to examine the clinical outcomes of hemiarthroplasties using posterior femoral trochanter osteotomy for the treatment of femoral neck fractures in patients at the sequelae stage of cerebrovascular disease.
A retrospective analysis was conducted on the data of 53 patients who had been admitted to the Department of Orthopedics at Yan'an University Affiliated Hospital between May 2020 and May 2023. These patients had been diagnosed with femoral neck fractures and concurrent muscle weakness at the sequelae stage of cerebrovascular disease. The patients were divided into two groups: the osteotomy group (20 cases), which underwent hemiarthroplasties via an L osteotomy of the posterior femoral trochanter, and the conventional group (33 cases), which received hemiarthroplasties through the posterolateral approach of the greater trochanter. The two groups were compared on various parameters, including incision length, operation duration, intraoperative blood loss, postoperative drainage, blood transfusion rates, length of hospitalization, early mobilization post-surgery, hip joint function scores at follow-up visits (3 and 12 months), and the rate of postoperative dislocation of the femoral head.
No significant differences were observed between the two groups regarding incision length (=0.06), operation duration (=0.284), intraoperative blood loss (=0.925), Blood transfusion rate (P=0.489), postoperative drainage (=0.831) and length of hospital stay (=0.341). However, the early mobilization time following surgery was shorter in the osteotomy group compared to the conventional group (<0.001). Additionally, the Harris hip joint function scores for the osteotomy group were significantly higher than those for the conventional group at both the 3- and 12-month postoperative assessments (0.003, 0.004, respectively). The dislocation rate of the femoral head in the osteotomy group was lower than that in the conventional group with no statistical significance difference (=0.521).
The use of hemiarthroplasties via posterior femoral trochanter osteotomy demonstrates favorable clinical outcomes in the treatment of femoral neck fractures.
本研究旨在探讨采用股骨转子后截骨术进行半髋关节置换术治疗脑血管病后遗症期股骨颈骨折患者的临床疗效。
对2020年5月至2023年5月延安大学附属医院骨科收治的53例诊断为股骨颈骨折且合并脑血管病后遗症期肌肉无力的患者资料进行回顾性分析。将患者分为两组：截骨组（20例），采用股骨转子后L形截骨术进行半髋关节置换术；传统组（33例），采用经大转子后外侧入路进行半髋关节置换术。比较两组的各项参数，包括切口长度、手术时间、术中出血量、术后引流量、输血率、住院时间、术后早期活动情况、随访（3个月和12个月）时髋关节功能评分以及股骨头术后脱位率。
两组在切口长度（P = 0.06）、手术时间（P = 0.284）、术中出血量（P = 0.925）、输血率（P = 0.489）、术后引流量（P = 0.831）和住院时间（P = 0.341）方面差异均无统计学意义。然而，截骨组术后早期活动时间短于传统组（P < 0.001）。此外，截骨组在术后3个月和12个月的Harris髋关节功能评分均显著高于传统组（分别为P = 0.003、P = 0.004）。截骨组股骨头脱位率低于传统组，但差异无统计学意义（P = 0.521）。
采用股骨转子后截骨术进行半髋关节置换术治疗股骨颈骨折具有良好的临床疗效。
