人工股骨头置换治疗高龄股骨转子间骨折

Treatment of unstable intertrochanteric fractures in elderly patients with cemented bipolar prosthetic replacement

目的探讨人工股骨头置换治疗高龄股骨转子间骨折的可行性。方法 31例高龄不稳定性股骨转子间骨折患者采用双极人工股骨头置换,观察手术时间、出血量、Harris功能评分、并发症发生情况。结果手术时间60～105（75±12）min,术中出血300～700 ml。29例获随访（2例术后死亡）,时间6～28个月。患者均在术后1周逐步下地负重行走。按Harris评分标准：优19例,良7例,可3例。X线片示假体无松动、下沉。结论人工股骨头置换术治疗高龄不稳定性股骨转子间骨折合并骨质疏松患者具有卧床时间短、可早期下地负重、术后并发症低、早期髋关节功能恢复良好等优点,是一种有效的治疗方法。

Objective To evaluated the clinical results of the bipolar prosthetic replacement for the treatment of unstable intertrochanteric fractures in elderly patients.Methods 31 elderly patients with unstable intertrochanteric fractures were treated with bipolar prosthetic arthroplasty.The operation time,volume of blood loss,Harris rating scale,postoperative complications incidence were observed.Results Operation time was 60~105（75±12） min,with blood loss of 300～700 ml.29 patients（2cases were died） were followed up for 6～28 months.Walking with weight-bearing was begun in 1 week postoperation.According to Harris rating scale,19 cases were excellent,7 good,and 3 fair.X-ray showed no prosthetic loosening and sinking.Conclusions To treat unstable intertroehanteric fracture especially with osteoporosis in elderly patiens with cemented bipolar prosthetic arthroplasty has advantages of keeping bed time shorter after operation,allowing early weight-bearing,having low incidence of postoperative complications,early functional recovery of hip excellency et al,and the surgical approach is an effective method.