Abstract: 【Abstract】〓Objective〓To investigate the clinical outcome of femoral neck fracture treated with cannulated screw fixation and total hip replacement. Methods〓109 patients with fresh femoral neck fractures were divided into group A (total hip replacement, n=59), and group B (cannulated screws fixation, n=50). The operation time, blood loss, intraoperative fluoroscopy frequency, duration of hospitalization, bedridden time, complications and Harris hip joint functional score were recorded and compared between two groups. Results〓All patients got followed-up for 17-36 months. The patients in group B had smaller incision, less trauma, shorter operation time, less intraoperative blood loss than those in group A(P<0.05). The patients in group A had lower intraoperative fluoroscopy frequency, shorter duration of hospitalization, shorter bedridden time, lower post-operation complications (P<0.05). Cases of group A had higher Harris hip joint functional score than that in group B (P<0.05). Conclusion〓Total hip replacement has less complications and good prognosis, but has more trauma. The surgical approach is chosen on the basis of practical situation.

Key words: Femoral neck fracture, Total hip replacement, Internal fixation with cannulated screws, Outcome

摘要： 【摘要】〓目的〓比较全髋关节置换术及空心钛镙钉在治疗新鲜老龄股骨颈骨折上的临床疗效。方法〓因新鲜股骨颈骨折行手术治疗并获得随访的老龄患者109例(年龄>65岁),分为A组(全髋关节置换术)59例,B组(空心螺钉内固定)50例。对比分析两组患者手术时间、围手术期出血量、术中透视次数、住院时间、术后下地负重活动时间、并发症发生、术后患侧髋关节Harris评分。结果〓随访时间17~36个月,平均26个月。相比而言,闭合复位空心螺钉组手术切口小、创伤小、手术时间短、总出血量少(P<0.05);全髋关节置换组术中放射暴露少、术后卧床时间及住院时间短、术后并发症发生率低(P<0.05);全髋关节置换术后末次随访髋关节Harris评分显著高于空心螺钉组(P<0.05)。结论〓全髋关节疗效显著、术后并发症少,但创伤大,应根据患者情况有所选择手术方式。

关键词: 老龄股骨颈骨折, 全髋关节置换术, 空心螺钉内固定, 疗效