加长柄骨水泥型人工股骨头置换合张力带钢丝治疗老年股骨粗隆间骨折18例

Experience in the Treatment to the Unstable Intertrochanteric Fracture of Femur with Long Stem Cemented Femoral Head Replacement Combine Kirchner Wire Tension Band Wire in Elderly Patients

目的:评价加长柄骨水泥型人工股骨头置换合克氏针张力带钢丝治疗老年非稳定型股骨粗隆间骨折患者的疗效。方法:采用这种改良的固定方法对2009年10月-2011年4月收治的18例Evans分型为Ⅳ型伴不同程度骨质疏松的高龄非稳定型股骨粗隆间骨折患者行人工股骨头置换术。结果:随访6～18个月,平均10个月,未出现假体松动、下沉、脱位及假体周围骨折,其中优13例,良3例,尚可1例,差1例,优良率88.9%。结论:这种改良的新型固定方法治疗老年非稳定型股骨粗隆间骨折,符合生物力学原理,固定牢靠、下床早、并发症少、死亡率低,可明显提高患者术后生活质量,只要严格掌握病例选择标准,是一种具有较高临床实用性和推广性的方法。

Objective：To observe the effect of long stem cemented femoral head replacement combine Kirchner wire tension band wire（a new fixed method） in the treatment to unstable intertrochanteric fracture of femur in elderly patients.Methods：18 cases with unstable intertrochanteric fracture of femur（type Ⅳ by Evans classification） collected from Oct 2009 to Apr 2011 were treated with this improved fixed method.Results：The average duration of follow-up was 10 months（range,6 to 18 months） for all patients.Loosening,subsidence and dislocation of the prosthesis,and periprosthetic fracture were not appeared.13 cases were rated as excellent,3 good,1 fair,and 1 poor.The excellent and good rate was 88.9%.Conclusions：The new fixed method meets the biomechanics principles and fixed firmly.It had less complication,low mortality and shorter time in bed,and it can obviously improve the quality of life.It is a bold attempt and beneficial exploration.This method was worthy of popularizing and implementation,if strictly mastered.