混合型人工全髋关节置换术治疗老年股骨颈骨折(英文)

Hybrid total hip arthroplasty treating femoral neck fracture of elderly patients

目的 随访一组经混合型全髋关节置换术的股骨颈骨折老年的患者 ,了解骨水泥型股骨假体和非骨水泥型髋臼假体的组合应用于健康和骨质质量较差的老年患者的情况。方法 4 1名患者得到临床和影像学随访。随访内容包括老年患者的健康状况、手术方法、术后恢复情况以及对于骨形态、骨水泥固定质量和假体稳定性。结果 未出现与骨水泥相关的术中和或术后死亡 ,各类全身性疾病在围手术期无加重表现。Harris评分为 81 1分。股骨近端骨形态A型占 2 0 % ,B型 5 6 % ,C型 2 4 %。骨水泥固定质量分为A级 37% ,B级 4 9% ,C级 4 %。结论 混合型人工关节置换术对老年股骨颈骨折患者较为适用。混合型人工关节的术后即时稳定性有利于老年患者的康复。在手术中必须应用现代骨水泥技术。

Objective To follow up a series of elderly patients who had acute femoral neck fracture, and to examine the performance of the combination of cemented stem and acetabular cup. Methods Forty_one elderly patients were followed up.The average age at operation was 72 1 years and follow-up was 3 2 years. Evaluations on the outcomes of hybrid hip arthroplasty included morphologic feature of bone, quality of cement mantle,and implant stability. Results No cement-related death intra- or postoperatively was documented and systemic diseases did not deteriorate peri-operatively. The total Harris Hip Score was 81 1 points. The bone type was evaluated as Type A, 20%; Type B,56%;Type C,24%. Quality of cement mantle was evaluated as Grade A, 37%; Grade B, 49%;and Grade C, 4%. Conclusion Hybrid total hip replacement is preferred in the elderly with acute femoral neck fracture.The immediate postoperative stability enables quicker rehabilitation of elderly patients and lowers the incidence of complications.Contemporary cementing techniques are mandatory in the operation.