人工股骨头假体置换与高龄股骨转子间粉碎性骨折

Artificial femoral head prosthetic replacement and femur intertrochanteric comminuted fracture of elderly patients

目的:探讨人工股骨头假体材料的选择,以及人工股骨头假体在治疗高龄患者股骨转子间粉碎性骨折的疗效。方法:作者用计算机检索中国期刊全文数据库(CNKI:1977/2009)和Medline database(1977/2009)数据库,检索词分别为"股骨转子间粉碎骨折;人工股骨头置换术;高龄患者"和"femur intertrochanteric fracture;artificial femoral head arthroplasty;elderly patient",语言分别设定为中文和英文。共检索到83篇文献,按纳入和排除标准对文献进行筛选,共纳入34篇文献。分别以人工股骨头假体的材料学研究、老年股骨转子间骨折的治疗和人工股骨头假体置换治疗老年股骨转子间骨折的临床应用等问题出发进行归纳和总结,探讨人工股骨头假体治疗高龄股骨转子间骨折的疗效。结果:人工股骨头假体在治疗各种股骨转子间骨折中均得到了广泛的临床应用,已有多种材料类型的人工股骨头假体如金属材料、高分子聚乙烯、陶瓷材料以及碳质材料等应用于临床,并取得了显著的疗效。人工股骨头假体的功能日趋完善,在临床应用中愈加广泛,是目前治疗高龄股骨转子间粉碎性骨折的最有效方法,但此方法仍存在着手术风险大、并发症多等需要解决的问题。结论:人工股骨头假体选择的材料有很多种,各有其优缺点,目前临床上多采用复合型人工股骨头假体材料;人工股骨头假体是治疗高龄股骨转子间粉碎性骨折较为理想的方法。

OBJECTIVE： To discuss the choice of artificial thigh bone prosthetic material and curative effects of artificial thigh bone prosthesis for treating femur intertrochanteric comminuted fracture of senior patients. METHODS： We retrieved China National Knowledge Infrastructure （CNKI） in Chinese （1977/2009） and Medline database in English （1977/2009） with the Keywords of ＂femur intertrochanteric fracture; artificial femoral head arthroplasty; elderly patient＂. Totally 83 articles were retrieved, and 34 articles were included in accordance with inclusion and exclusion criteria. Literatures addressing artificial thigh bone prosthesis, intertrochanteric fracture in elderly patients and artificial femoral head replacement in treatment of femur intertrochanteric fracture were summarized, and curative effect of artificial thigh bone prosthesis for treating intertrochanteric fracture in elderly patients was explored. RESULTS： Artificial thigh bone prosthesis had been widely used in treatment of various femur intertrochanteric fractures. There are many types of artificial thigh bone prosthesis such as metal material, high polymer polyethylene, ceramic material and carbon material, which had obtained significant outcomes. Function of artificial thigh bone prosthesis was improved gradually, and became widely in clinic. Artificial thigh bone prosthesis has presently been an optimal method for treating femur intertrochanteric comminuted fracture in elderly patients. However, this method exist many problems that require to be solved such as high operation risk and many complications. CONCLUSION： There are many materials for choosing artificial thigh bone prosthesis, with various advantages and disadvantages. Presently, complex artificial thigh bone prosthesis is commonly used in clinic. Artificial thigh bone prosthesis is an ideal method to treat femur intertrochanteric comminuted fracture of elderly patients.