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首页> 外文期刊>International Journal of Research in Medical Sciences >An evaluation of merits of total hip arthroplasty done for traumatic and non-traumatic displaced fracture neck of femur
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An evaluation of merits of total hip arthroplasty done for traumatic and non-traumatic displaced fracture neck of femur

机译：股骨外伤性和非创伤性移位性颈全髋置换术的优点评估

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Background: There is ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. Paucity of quality data provides an opportunity for extension of this debate. The aim of this study was planned to evaluate merits (outcomes and complications) of total hip arthroplasty done for traumatic and non traumatic displaced fracture neck of femur. Methods: A comparative evaluation was undertaken among 50 patients who underwent total hip replacement at a tertiary care center. A retrospective cohort of fifty patients treated with total hip replacement for traumatic causes of displaced fracture neck of femur (25 patients) and non-traumatic causes of displaced fracture neck of femur (25 patients) were included in this study. The inclusion criteria's for the traumatic group were acute displaced fracture neck of femur above 50 years and fracture neck with fracture head with dislocation above 50 years. Patients having nonunion fracture neck of femur, failed cancellous screw fixation, intertrochantric fractures and associated acetabulum fractures were excluded from this study. Results: On clinical and functional evaluation, patients scored 84% excellent/good in non-traumatic group whereas 68% excellent/good score in traumatic group. 12% and 16% patients scored poor in non-traumatic group and in traumatic group respectively. In non-traumatic group, following complications were observed. Dislocation rate of 4% (one hip), 4% incidence of aseptic acetabular loosening (one hip), and 16% incidence of heterotrophic ossification (four hips). In traumatic group, we observed 2 (8%) dislocations, 4 (16%) heterotopic ossifications. Loosening of acetabulum and subsidence were observed in two (8%) patients. Conclusions: There are higher chances of dislocation among patients undergoing total hip replacement for a traumatic indications as compared to their non-traumatic indications. Chances of dislocation can be curtailed by keeping known factors in mind along with careful patient selection, adherence to postoperative protocol and use of a lateral approach with large head in high risk patients.
机译：背景：在特定的患者群体中，关于不同类型的关节置换术的相对价值存在争议。质量数据的匮乏为扩大这场辩论提供了机会。这项研究的目的是为了评估股骨外伤性和非外伤性移位性颈全髋置换术的优点（结果和并发症）。方法：对三级护理中心接受全髋关节置换术的50例患者进行了比较评估。这项回顾性队列研究包括了50例接受全髋关节置换术治疗的股骨骨折颈移位的外伤原因（25例）和非创伤性股骨骨折颈移位的非病因（25例）。创伤组的入选标准为50岁以上的急性移位的股骨骨折颈和50岁以上的具有脱位的骨折颈的骨折颈。本研究排除了股骨颈不愈合，松质螺钉固定失败，股骨转子间骨折及相关髋臼骨折的患者。结果：在临床和功能评估中，非创伤组患者得分为84％（好/好），而创伤组患者得分为68％（好/好）。非创伤组和创伤组分别有12％和16％的患者评分较差。在非创伤组，观察到以下并发症。脱位率为4％（一只髋），无菌髋臼松动发生率为4％（一只髋），异养骨化发生率为16％（四个髋）。在外伤组中，我们观察到2（8％）位错，4（16％）异位骨化。在两名（8％）患者中观察到髋臼松弛和下陷。结论：与非创伤性适应症相比，接受全髋置换术治疗的创伤适应症患者脱位的可能性更高。在高风险患者中，应牢记已知因素，并仔细选择患者，遵守术后规程和采用大头侧位方法，以减少脱位的可能性。

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