人工股骨头置换在高龄骨质疏松非稳定性股骨粗隆间骨折中的应用

Application of artificial femoral head replacement to advanced age patients with osreoporosis and unstable intertrochanteric femur fractures

目的总结高龄老年骨质疏松非稳定性股骨粗隆间骨折采用人工股骨头置换治疗的临床疗效，探讨关节置换手术的优越性。方法本组27高龄老年骨质疏松非稳定性股骨粗隆间骨折早期应用人工双极股骨头置换术治疗，观察术中出血量，手术时间、住院天数等。结果27例患者均顺利通过手术，住院期间无死亡病例，术后3～9d（平均5．5d）下地负重行走，住院时间16～27d，平均21d。27例出院后得到随诊，随诊时间6～36个月，平均21个月。1例患者术后3个月因肺部感染死亡，其余患者均在术后3—6个月恢复生活自理能力。结论高龄老年骨质疏松非稳定性股骨粗隆间骨折早期应用人工双动股骨头置换术，手术安全、患者能早期离床运动、并发症少、死亡率低，是一种有效的治疗手段，但远期效果仍需继续观察。

Objective To summary the clinical efficacy of artificial femoral head replacement to advanced age patients with osreoporosis and unstable intertroehanteric femur fractures and discuss the superiority of joint replacement. Methods 27 patients with with osreoporosis and unstable intertrochanteric femur fractures were accepted artificial femoral head replacement early. Bleeding amount, operation time and hospital stay time etc were observed. Results All of the 27 patients smoothly passed the surgery and no cases died in hospital period. After 3 to 9 days（ average 5.5 days） , patients could walk on ground with weight bearing and the time in hospital was 16 to 27 days,average 21days. The 27 patients all got followed-up for 6 to 36 months, average 21 months. One patient died of the lung infection in three months later and other patients all get life self-care ability back in 3 to 6 months after operation. Conclusion Artificial femoral head replacement to advanced age patients with osreoporosis and unstable intertrochanteric femur fractures is safe with little complication and low death rate and patients can do exercise out of bed early. It is an effective treatment method, but its long-time effect must continue to observe.