高龄老人股骨颈骨质疏松性骨折的治疗

Treatment of osteoporotic fracture of femoral neck in people aged over 80

目的总结80岁以上股骨颈骨折患者的外科治疗结果。方法1996年1月至2003年12月收治80岁以上股骨颈骨折69例,其中38例接受了骨水泥型人工股骨头置换术,术前存在内科并发症者占84%,15例对健侧股骨近端行骨密度测定,均提示存在骨质疏松。结果38例均顺利完成手术,切口无感染,随访6个月～5年者有30例,有5例死亡。结论强调高龄股骨颈骨折的治疗应积极防治内科并发症和骨质疏松,争取早日行骨水泥型人工股骨头置换术。

Objective To analyze the clinical results of surgical treatment for femoral neck fracture in people over 80. Methods Thirty-eight of 69 patients older than 80 years of age had the artificial femoral head replacement surgery from January 1996 to December 2003. 84% of the operated patients had internal medical complications before the operation. Bone density measurement of the opposite proximal part of femur showed osteoporosis in all 15 patients who had the test. Results Surgical procedures were successful in 38 patients without infection. Thirty patients were followed up from 6 months to 5 years among which 5 were dead, Twenty-four patients were able to walk and thirty take care of themselves. Conclusions Aggressive treatment and prevention of the medical complications and osteoporosis is necessary for the elderly with fracture of femoral neck. Early artificial femoral head replacement surgery with cement is recommened if indicated.