人工股骨头置换术治疗高龄不稳定性股骨转子间骨折

Artificial Femoral Head Replacement for the Treatment of Elderly Unstable Intertrochanteric Fracture

目的:探讨骨水泥型双极人工股骨头置换术治疗高龄不稳定性股骨转子间骨折的临床疗效。方法2007年7月~2014年2月,采用骨水泥型双极人工股骨头置换术治疗高龄不稳定性股骨转子间骨折41例(I I型23例,IV型16例,V型2例),观察术后并发症及髋关节功能。结果手术时间56~100min,平均68.6min,术中出血约200~600ml,平均280ml;所有患者术后2~3d即扶助行器下地负重站立、行走;随访6~36个月,平均24个月,未见畸形、感染、假体松动、下沉及脱位发生,3~6个月基本恢复到伤前髋关节功能。术后6个月Har is评分院优20例,良17例,中3例,差1例;优良率90.2%。结论骨水泥型双极人工股骨头置换具有手术时间短,即刻稳定,早期下地负重,显著减少卧床并发症,关节功能迅速恢复到伤前水平等优点,对于高龄不稳定性股骨转子间骨折是比较理想的手术方式之一。

Objective To explore the ef ect of cemented femoral head replacement of comminuted unstable intetrochanteric fracture of femur in the elderly.Methods Cemented bipolar artificial femoral head replacements were used to treat 41 cases of interochanteric fracture of femur in the elderly from July 2007 to February 2014.According to Evans classification,23cases of the fracture were type II,16cases were type IV and 2cases were type V.Har is Hip Score System and radiography were used to evaluate the clinical ef iciency.Results The operation time was 56~100min(average 68.6min),the intra-operative blood loss was 200~600 ml(average 280ml).The time of weight-bearing was 2-3day after the operation.41 patients were fol owed up for 6~36 months(average 24months).The hip joint function recovered wel in those patients.no varus,infection,loosening,dislocation was found.According to the six-month Har is hip function score,20 cases were excellent,17 good,3 fair,and 1 poor.The good rate was 90.2%.Conclusion Cemented bipolar artificial femoral head prosthetic replacement for the treatment of senile intertrochanteric fractures has many advantages,short operation time,weight-bearing activities earlier,functional recovery postoperatively,avoiding complications of bed-ridden,etc.The treatment is a bet er reasonable operation method to unstable intertrochanteric fracture of the femur in the elderly.