Abstract：
OBJECTIVE: To compare and analyze the early clinical effect of direct superior approach(DSA) and posterior lateral approach (PLA) in hemiarthroplasty for elderly patients with femoral neck fracture.
METHODS: The clinical data of 72 elderly patients with femoral neck fracture who underwent hemiarthroplasty from January 2020 to December 2021 were retrospectively analyzed. Among them, 36 patients were operated through minimally invasive DSA including 10 males and 26 females with an average age of (82.82±4.05) years old; the other 36 patients underwent traditional PLA including 14 males and 22 females with an average age of (82.79±3.21) years old. The perioperative related indexes and Harris scores during follow-up between two groups were compared.
RESULTS: Comparison of operation time between two groups, (79.41±17.39) min of DSA group was shorter than(98.45±26.58) min of PLA group;incision length (8.33±2.69) cm was shorter than (11.18±1.33) cm of PLA group;intraoperative blood loss (138.46±71.58) ml was less than (173.51±87.17) ml of PLA group, initial landing time (3.04±0.95) d was earlier than (4.52±1.10) d of PLA group, hospitalization time (8.70±1.89) d was shorter than (10.67±2.35) d of PLA group(P<0.05). There was no statistical difference in Harris score between two groups before operation(P>0.05), but Harris score in DSA group was higher than that of PLA group at 1 month after operation(P<0.05), but at 12 months after operation, the difference was not statistically significant between two groups(P>0.05).
CONCLUSIONS: Compared with PLA, DSA is superior in clinical indexes such as operation time, intraoperative blood loss, incision length, first landing time, length of hospitalization and Harris score in the first month after operation in hemi hip replacement, and has comparative advantages in promoting early postoperative rehabilitation of elderly patients with femoral neck.
METHODS: The clinical data of 72 elderly patients with femoral neck fracture who underwent hemiarthroplasty from January 2020 to December 2021 were retrospectively analyzed. Among them, 36 patients were operated through minimally invasive DSA including 10 males and 26 females with an average age of (82.82±4.05) years old; the other 36 patients underwent traditional PLA including 14 males and 22 females with an average age of (82.79±3.21) years old. The perioperative related indexes and Harris scores during follow-up between two groups were compared.
RESULTS: Comparison of operation time between two groups, (79.41±17.39) min of DSA group was shorter than(98.45±26.58) min of PLA group;incision length (8.33±2.69) cm was shorter than (11.18±1.33) cm of PLA group;intraoperative blood loss (138.46±71.58) ml was less than (173.51±87.17) ml of PLA group, initial landing time (3.04±0.95) d was earlier than (4.52±1.10) d of PLA group, hospitalization time (8.70±1.89) d was shorter than (10.67±2.35) d of PLA group(P<0.05). There was no statistical difference in Harris score between two groups before operation(P>0.05), but Harris score in DSA group was higher than that of PLA group at 1 month after operation(P<0.05), but at 12 months after operation, the difference was not statistically significant between two groups(P>0.05).
CONCLUSIONS: Compared with PLA, DSA is superior in clinical indexes such as operation time, intraoperative blood loss, incision length, first landing time, length of hospitalization and Harris score in the first month after operation in hemi hip replacement, and has comparative advantages in promoting early postoperative rehabilitation of elderly patients with femoral neck.
摘要：
目的：对比分析直接上入路(DSA)与后外侧入路(PLA)在老年股骨颈骨折人工股骨头置换术中的早期临床效果。
方法：回顾性分析2020年1月至2021年12月行人工股骨头置换术的72例老年股骨颈骨折患者的临床资料。其中,36例患者行微创DSA手术，男10例，女26例，平均年龄（82.82±4.05）岁；其余36例患者行传统PLA手术，男14例，女22例，平均年龄（82.79±3.21）岁。比较两组患者围手术期相关指标及随访期间Harris评分。
结果：两组手术时间比较，DSA组的（79.41±17.39）min短于PLA组的（98.45±26.58）min；切口长度（8.33±2.69）cm短于PLA组的（11.18±1.33）cm；术中出血量（138.46±71.58）ml少于PLA组的（173.51±87.17）ml。初始着陆时间(3.04±0.95)d早于PLA组(4.52±1.10)d,PLA组住院时间(8.70±1.89)d短于(10.67±2.35)d(P<0.05)。两组患者术前Harris评分比较差异无统计学意义(P>0.05)。术后1个月DSA组Harris评分高于PLA组(P<0.05),但手术后12个月,两组间差异无统计学意义(P>0.05)。
结论：与PLA相比，DSA在手术时间、术中失血,切口长度,首次着陆时间,半髋关节置换术后1个月的住院时间和Harris评分，在促进老年股骨颈患者术后早期康复方面具有比较优势。
方法：回顾性分析2020年1月至2021年12月行人工股骨头置换术的72例老年股骨颈骨折患者的临床资料。其中,36例患者行微创DSA手术，男10例，女26例，平均年龄（82.82±4.05）岁；其余36例患者行传统PLA手术，男14例，女22例，平均年龄（82.79±3.21）岁。比较两组患者围手术期相关指标及随访期间Harris评分。
结果：两组手术时间比较，DSA组的（79.41±17.39）min短于PLA组的（98.45±26.58）min；切口长度（8.33±2.69）cm短于PLA组的（11.18±1.33）cm；术中出血量（138.46±71.58）ml少于PLA组的（173.51±87.17）ml。初始着陆时间(3.04±0.95)d早于PLA组(4.52±1.10)d,PLA组住院时间(8.70±1.89)d短于(10.67±2.35)d(P<0.05)。两组患者术前Harris评分比较差异无统计学意义(P>0.05)。术后1个月DSA组Harris评分高于PLA组(P<0.05),但手术后12个月,两组间差异无统计学意义(P>0.05)。
结论：与PLA相比，DSA在手术时间、术中失血,切口长度,首次着陆时间,半髋关节置换术后1个月的住院时间和Harris评分，在促进老年股骨颈患者术后早期康复方面具有比较优势。
