加长柄人工双极股骨头置换治疗高龄股骨转子间骨折

Long-stem Bipolar Femoral Head Prosthetic Replacement for Elderly Patients with Femoral Intertrochanteric Fracture

目的探讨加长柄人工双极股骨头置换治疗高龄股骨转子间骨折的疗效。方法用标准人工骨水泥、加长柄人工双极股骨头治疗高龄股骨转子间骨折病人41例。结果41例平均手术时间65min,平均输血600ml。术后3d下地12例,7d下地21例,14d下地8例。术后并发肺部感染、菌群失调2例,电解质代谢紊乱6例,低蛋白血症9例。随访3～41个月,按Har-ris评分标准:优良率达85.4%。无人工关节脱位、松动及假体下沉,无晚期感染病例。结论用加长柄人工双极股骨头治疗高龄股骨转子间骨折,是一种较好的治疗方法,可早期下地锻炼,减少并发症,提高生活质量。

Objective To investigate the therapeutic effect of the long- stem bipolar femoral head prosthetic replacement for elderly pa- tients with femoral intertrochanteric fracture. Methods Forty - one elderly patients with femoral intertrochanteric fracture were treated with the long - stem cemented bipolar femoral head prosthetic replacement. Results The average duration of operation was 65 min. All patients accepted an average of 600 ml blood transfusion during the operation. Twelve patients got out of the bed after 3 days, 21 patients after 7 days and 8 patients after 14 days. Complications were as following： Pulmonary infection and dysbacteria was in 2 patients, disturbance of electrolytes balance in 6 patients and hypoproteinemia in 9 patients. Forty - one patients were followed up for 3 to 41 months and no one died. Eighty five point four per cent patients achieved satisfactory results according to harris rating scale. No prosthe- sis dislocation, loosening and sinking occurred. No patient had delayed infections. Conclusion It＇s an effective method to treat femoral intertrochanteric fractures in elderly patients with the long - stem bipolar femoral head prosthetic replacement. The result is satisfactory and it has advantages such as earlier weight- bearing, less complications, and better life quality.