人工股骨头置换治疗老年不稳定型股骨粗隆间骨折

Artificial femoral head arthroplasty in the treatment of unstable intertrochanteric fractures in elderly patients

目的探讨人工股骨头置换治疗老年不稳定型股骨粗隆间骨折的疗效。方法2003年7月至2005年12月收治合并骨质疏松的老年不稳定型股骨粗隆间骨折19例，Tronzo-Evans分型：Ⅲ型10例，Ⅳ型9例，所有忠者都施行了骨水泥型人工股骨头置换。结果19例患者郁顺利通过手术，平均手术时间60min。围手术期因肺栓塞死亡1例，并发肺部感染1例，深静脉血栓2例，老年性精神障碍3例。无关节感染、脱位、假体周围骨折等并发症发生。随访6～18个月，平均10个月，16例患者获完整随访资料，Harris评分优5例，良8例，优良率81.3％。结论人工股骨头置换是治疗老年不稳定型股骨粗隆间骨折的有效方法，手术创伤小，并发症少，能早期离床活动，显著提高了患者的生活质量。

Objective To explore the effect of artificial femoral head arthroplasty in the treatment for unstable intertroehanteric fractures in elderly patients. Methods Nineteen elderly patients with unstable intcrtrochanteric fractures was collected from July in 2003 to December in 2005. According to the Tronzo-Evans classification,there were 10 cases in type Ⅲ,9 cases in type IV. All patients were treated with artificial femoral head arthroplasty. Results All patients were underment successfully,and operative time was an hour averagely. One case of pulmonary infection ,two cases of deep vein thrombus formation and three cases of elderly nrental disorder were observed. One case was died of lung embol- ism. Complications such as articulation infection and dislocation, fracture around prosthesis had not happened, sixteen cases were followed up for 6 to 18 months,average 10 month. According Harris scoring system,81.3% are good. Conehtsions Artificial femoral head arthroplasty is an ef-fective way in the treatment of unstable intertrochanteric fractures in elderly patients,whlch has less trauma and less eomplieatiens. It could let patients have early physical exercises and improve the patient＇s living quality significantly.