人工双极股骨头置换治疗高龄股骨转子间骨折

Bipolar Artificial Femoral Head Prosthetic Replacement for Elderly Patients with Femoral Intertrochanteric Fracture

目的探讨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、人工双极股骨头置换治疗高龄股骨转子间骨折患者36例。结果36例平均手术时间70 min,平均输血400 ml。术后36例第2天都可坐起,3 d下地10例,7 d下地15例,14 d下地6例,1月下地5例。术后并发肺部感染2例,电解质紊乱6例,低蛋白血症7例。随访3～48个月,按Harris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。结论人工双极股骨头置换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 bipolar femoral head prosthetic replacement（BFHPR） for elderly patients with intertrochanteric fracture（IF）. Methods Thirty-six elderly patients with IF were treated with the cemented BFHPR. Results The average duration of operation was 65 min, All patients accepted an average of 600 ml blood transfusion during the operation. All patients could take a seat by themselves after 2 days. Ten patients got out of the bed after 3 days, 15 patients after 7 clays ,6 patients after 14 clays and 5 patients after one month. Complications were as following： Pulmonary infection was in 2 patients, disturbance of electrolytes balance in 6 patients and hypoproteinemia in 9 patients. 36 patients were followed up for 3 to 48 months and no one died. 85.4% patients achieved satisfactory results according to Harris rating scale. No prosthesis dislocation,loosening and sinking occurred. No patient had delayed infections. Conclusion BFHPR is an effective method for senile femoral IF, and has advantages such as earlier weight-bearing, less complications, and better life quality.