人工股骨头假体置换与高龄股骨转子间粉碎性骨折

Femoral head prosthesis replacement and femur intertrochanteric comminuted fracture

目的:对人工股骨头假体的分类、性质及其在骨科高龄股骨转子间骨折的应用进行归纳总结。方法:第一作者应用计算机检索PubMed数据库及CNKI数据库,在标题和摘要中以"人工股骨头假体,置换,高龄,股骨转子间粉碎性骨折"或"artificial femoral head prosthetic,replace,elderly patients,femur intertrochanteric comminuted fracture"为检索词进行检索。选择文章与检索关键词相关,同一领域文献则选择近期发表或发表在权威杂志文章。共纳入29篇文献。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 summarize the classification and features of head prosthesis and to analyze its application in treating elderly femur intertrochanteric comminuted fractures. METHODS： Databases of PubMed and CNKI were searched by the first author using of ＂artificial femoral head prosthetic, replace, elderly patients, femur intertrochanteric comminuted fracture＂ both in English and Chinese. Documents published recently or in authoritative journals were preferred. A total of 29 papers were included in this paper. RESULTS： Femoral head prosthesis had been widely used in treating femur intertrochanteric fractures. Many kinds of the femoral head prostheses, such as metal materials, macromolecular polyethylene, ceramics and carbonaceous materials have been applied in the clinic, and received good therapeutic effects. Femoral head prosthesis is one of the most effective methods for treating femur intertrochanteric comminuted fractures, but the problems including high operation risks and complications need to be solved. CONCLUSION： Plenty of materials are involved in preparing artificial femoral head prosthesis with unique advantages and drawbacks. The composite materials are preferred in the clinic. Femoral head prosthesis is an ideal method for treating elderly femur intertrochanteric comminuted fractures.