大直径球头-骨水泥型人工髋关节置换治疗帕金森患者股骨颈骨折12例

Large-diameter femoral head-cemented hip arthroplasty for treating 12 patients with Paikinsonism involving the femoral neck fracture

目的:探讨采用大直径球头-骨水泥型人工髋关节置换的方法,治疗老年帕金森患者股骨颈骨折的临床疗效。方法:回顾性病例分析2007年1月至2010年10月收治的帕金森患者合并股骨颈骨折12例,男3例,女9例,年龄65岁至87岁,平均年龄76.17岁。假体类型:人工全髋关节假体2例,人工双极股骨头10例。置换后3个月随访,进行围置换期并发症、影像学、髋关节功能评分(Harris评分)等方法评价手术效果。结果:所有患者均安全度过围置换期,置换术后3周出现脱位1例,无深部感染及深静脉血栓形成,无围手术期死亡病例;骨盆平片上出现髋臼侧透亮线1例,无骨溶解、松动及股骨柄下沉;Harris评分:90分至100分3例,80分至89分5例,70分至79分3例,<70分1例。结论:大直径球头-骨水泥型人工髋关节置换治疗老年帕金森患者股骨颈骨折可有效改善关节功能,减少并发症,降低脱位率,提高患者生活质量。

Objective： To study the clinical effect of large-diameter femoral head-cemented hip arthroplasty in the surgical treatment of 12 patients with Parkinsonism involving the femoral neck fracture.Methods： From January 2007 to October 2010,we retrospectively analyzed 12 cases,including 3 males and 9 females with an average age of 76.17 years.All patients were treated with artificial prosthesis replacement,including 2 cases received total hip arthroplasty and 10 underwent bipolar artificial femoral head replacement.The patients were followed up since 3 months and evaluated clinically and radiographically respectively for the safety of replacement,hip function by Harris score.Result： All patients were safe through the perioperative.One case had hip dislocation in 3 weeks after replacement.There were no infections or death during the perioperative period.The radiolucent line happened in 2,but there was no osteolysis,prosthesis,loosening and femoral stem subsidence.According to the Harris scoring system,the patients were rated as 90~100 in 3,80~89 in 5,70~79 in 3 and 70 in 1.Conclusion： Large-diameter femoral head-cemented hip arthroplasty in patients with femoral neck fracture in elderly patients with Parkinsonism may decrease complications and dislocation rate to improve joint functional recovery and quality of life.