人工股骨头置换术治疗高龄股骨粗隆间不稳定性骨折

Artificial Femoral Head Replacement for the Treatment of Elderly Patients Unstable Intertrochanter Fracture

目的评估人工股骨头置换术治疗高龄股骨粗隆间不稳定性骨折的临床疗效。方法对15例高龄股骨粗隆间不稳定性骨折采用人工股骨头置换术治疗。观察住院时间、手术时间、术中出血量、下床时间及负重时间、并发症及死亡率。随访6 28个月,平均18个月。结果平均住院17.8d,术中平均出血量380ml,术后1 2周能扶拐下床,术后3 6周扶双拐行走,术后3 6个月肢体功能基本恢复到伤前水平,无1例死于术后并发症。随访期1例体胖女性术后2年髋臼磨穿,股骨头中心性脱位。Harris髋关节功能评分:优6例,良11例,可3例,差1例,优良率80.9%。结论人工股骨头置换术治疗高龄股骨粗隆间不稳定骨折能减少骨折并发症的发生,患者能早期活动,保留髋关节生理功能。提高生活质量。

Objective To evaluation the effection of artificial femoral head replacement for the treatment of elderly patients unstable intertrochanter fracture. Methods 15 elderly patients with unstable intertrochanter fracture were treated by artificial femoral head replacement. The figure of hospitalization period, time of operation, bleeding quantity of bleeding during operation, time of burden, adverse effeetion and rate of death were observed. The time of follow-up 6-28 months with an average of 22 months. Results Average inpatient time was 17.8 days, 380 ml bleeding in operation, and 1 -2 weeks and 3 -6 weeks after operation, patients could move and walk with the help of sticks. Recovery of leg＇s function in 3 -6 months after operation, and no death occurred due to adverse effect. Broken acetabulum and dislocation of center of fomoral head appeared in one fat woman 2 years after operation. Harris evaluation was： excerllent 6 cases, superor 11 cases, average 3 cases and inferior 1 case. The superor rate reached 80.90. Conclusion The operation can decrease the fracture adverse effect, earlier movement, matain function of acetabular, improve the quality of life.