人工股骨头置换治疗高龄不稳定型股骨粗隆间骨折32例报告

Report of hip hemiarthroplasty in the treatment of 32 cases of senile unstable intertrochanteric fracture

目的:探讨人工股骨头置换治疗高龄不稳定型股骨粗隆间骨折的临床疗效。方法:对2000年6月～2010年1月我院高龄不稳定型股骨粗隆间骨折32例进行人工股骨头置换术治疗,其中,应用骨水泥人工双极股骨头20例,应用非骨水泥生物型长柄人工双极股骨头12例。分析其手术时间、总出血量、总输血量、术前与术后Harris评分及术后并发症等。结果:本组32例患者成功渡过围手术期,手术时间(85.5±20.5)min,手术出血量(640.4±56.5)ml,手术输血量(602.5±20.5)ml,术前Harris评分(39.5±11.5)分,术后Harris评分(91.5±6.5)分,术后与术前Harris评分比较差异有统计学意义(t=14.4164,P<0.01)。术后随访6～24个月,X线检查示假体位置良好。术后并发症中,脱位1例,精神症状2例。本组无肺栓塞、深静脉血栓形成、感染等并发症发生。结论:人工股骨头置换术是治疗高龄不稳定型股骨粗隆间骨折的有效方法。

Objective：To explore the clinical effect of hip hemiarthroplasty in the treatment of senile unstable intertrochanteric fracture. Methods：32 patients with senile unstable intertroehanteric fracture were treated with hip hemiarthreplasty（HHA） between June 2000 and January 2010.20 cases of application of the cemented bipolar femoral head prosthesis, 12 cases of application of the long - stem non - cemented bipolar femoral head prosthe- sis, Analyzed the operating duration, the total amount of blood loss, the amount of blood transfusion necessary, preoperative and postoperative Harris scores and post - operative complications and so on. Results： 32 patients successfully through perioperative period, the average operation time was （ 85.5± 20.5 ） min, the average total amount of blood loss was （640.4 ± 56.5 ） ml, the average amount of operation blood transfusion was （ 602.5 ±20.5 ） ml, preoperative Harris score was （ 39.5 ± 11.5 ） points, postoperative Harris score was （91.5 ± 6.5 ） points, there was statistical difference between preoper- ative and postoperative Harris score（ （ t = 14. 4164 ,P 〈 0.01 ）. Followed up for 6 - 24 months, the position of the components were satisfactory. The postoperative complications in 3 eases,the dislocation of hips in 1 ease,and mental symptoms in 2 eases,and no others complications. Conclusion：Hip hemiarthreplasty is a effective method for treating senile unstable intertroehanteric fracture.