长柄双动人工股骨头置换治疗高龄不稳定股骨粗隆部骨折21例报告

A Report of 21 Patients with Long-Stem Bipolar Prosthetic Replacement on the Treatment of Comminuted Intertrochanteric Fracture of Hip in the Elderly Osteoporotic Patients

目的：探讨长柄双动人工股骨头置换治疗高龄股骨转子间粉碎性骨折的临床应用。方法：2004年1月-2007年6月选用双极长柄人工股骨头置换治疗75岁以上股骨转子间粉碎性骨折21例，男9例，女12例，年龄75～92岁。对住院时间、术后负重、行走时间、并发症及术后病死率进行随访观察。结果：21例术后均获6个月～3．5年随访，平均21．5个月。住院时间平均16d，术后17例32d完全负重行走，2例因其他内科疾患扶拐行走，术后并发髋关节疼痛1例，术后1年死亡1例。结论：长柄双动人工股骨头置换治疗高龄粉碎性股骨转子间骨折，术后恢复良好，为治疗可选方法之一。

Objective To evaluate the clinical effect of long-stem bipolar prostheti replacement on the treatment of comminuted intertrochanteric fracture of hip in the elderly osteoporotic patients. Method From January 2004 to July 2007, 21 patients who were more than 75 years old with comminuted intertrochanteric fracture were treated with bipola long-stem prosthetic replacement. There were 9 males and 12 females （aged from 75 to 92）. The surgical approach and operative techn/que, the average course of treatment in hospital, the average time to ambulate with full-weight bearing on the operated limb after the operation, complication, and mortality were observed. Results All patients were followed up 6 to 3.5 years （21.5 months on average）. The average course of stay at hospital was 16 days. The average time to ambulate was 32 days. The incidence of the pain of the hip joint was 1/21, and two patients due to another disease was unable to walk without using two crutches. The mortality of the patients was 1/21 one year after the surgery. Conclusion Bipolar long-stemprosthetic replacement for the treament of comminuted intertrochanteric fractures in the elderly osteoporotic patients proves to be a suitable alternative.