S-ROM型组配式股骨假体应用于高龄股骨转子间骨折17例(英文)

S-ROM prosthesis for the elderly femoral intertrochantor fracture Report of 17 cases

回顾性分析2005-12/2008-10天津中医药大学第一附属医院骨科收治的高龄股骨转子间骨折患者17例,男6例,女11例,年龄81～97岁;均为急性摔伤,其中左侧8例,右侧9例。按照Evans-Jensen分型:ⅡA型2例,ⅡB型10例,Ⅱ型5列。全部患者均实施了人工股骨头置换,假体采用Depuy提供的S-ROM人工髋关节系统。记录置换时间,置换过程中出血量及置换后住院天数,观察围置换期并发症及髋关节活动度。17例患者置换均顺利完成,置换时间平均61min,置换过程中出血量平均435mL。3d内离床者2例,7d内离床者13例,余2例于置换后2周离床。住院时间平均19d。全部患者术后均获得随访,时间4.5～36.0个月,平均13.7个月,住院期间无死亡及严重的并发症,15例日常活动接近受伤前,1例持续低热,考虑有泌尿系感染,没有引起严重的并发症,1例因心肌梗死于置换后4.5个月死亡。关节屈曲90°～110°,所有患者除2例在助行器辅助下室内活动,3例因脑梗死住院外,其余置换后生活均可自理。提示S-ROM型组配式股骨假体显著缩短了置换时间,减少置换中出血,尤其对于高龄患者具有明显临床意义。

Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of [ⅠA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system （Depuy）. The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months （ranging 4.5 36.0 months）, postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had low-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°- 110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.