摘要
目的:探讨高龄患者不稳定型股骨粗隆间骨折行人工关节置换术的可行性及疗效。方法:回顾性分析2005年11月至2010年8月采用生物型人工股骨头行髋关节置换术治疗28例老年不稳定型股骨粗隆间骨折,男10例,女18例,年龄75～93岁,平均82.3岁。按Evans-Jensen分型,ⅡB型19例,Ⅲ型9例。骨质疏松按Singh指数分为Ⅳ级3例,Ⅲ级7例,Ⅱ级15例,Ⅰ级3例。结果:术后2例出现肺感染给予抗炎、化痰治疗后愈合,1例出现下肢深静脉血栓给予放置深静脉滤网、抗凝、活血治疗后好转。24例术后随访,2例随访期间死亡,患者随访时间10～48月,平均28月。末次随访时1例假体出现下沉,1例出现假体周围异位骨化、髋关节活动受限,1例出现假体周围骨折给予手术治疗后愈合。末次随访Harris得分为42～91分,优7例,良10例,可3例,差2例,优良率77.3%(17/22),未出现髋关节脱位及骨溶解。结论:生物型人工股骨头髋关节置换治疗老年不稳定型股骨粗隆间骨折是一种有效的术式,术后患者可以早期下床进行部分负重活动,防并发症,提高生活质量。
Objective： To explore and evaluate the feasibility of hemiarthroplasty for the treatment of unstable intertrochan- teric fractures in the elderly. Methods： A retrospective analysis of 28 cases of unstable intertrochanterie fractures treated with arti- ficial femoral hemiarthroplasty was conducted. Ten of 28 cases were males and eighteen were females, aged 82.3 years on the av- erage （ ranged 75 - 93 years）. Classified by Evans - Jensen, there were 9 cases of type m unstable intertrochanteric fractures and 19 cases of I[B unstable intertrochanteric fractures. By osteoperosis classification of singh index, there were 3 cases of IV, 7 cases of II1, 15 cases of 1I and 3 cases of ｜ . Results ： One case of venous thrombosis and one case of lung infection were found and cured by corresponding treatment. 24 patients were followed up, 2 patients died in the period of follow - up. Followed - up period ranged from 10 months to 48 months （28 months on the average）. There were complications of prosthesis sink （1 case）, heterotopic ossification （ 1 case）, fracture around prosthesis （ 1 case, cured by reoperation）. By Harris＇score, 7 cases were ex- cellent, 10 cases good, 3 cases ordinary and 2 cases poor. There were no complications of hip dislocation and osteolysis. Conclu- sion ： Biotype prosthetic replacement for the management of unstable intertrochanteric fractures in the elderly is desirable and sat- isfactory results can be obtained.
出处
《包头医学院学报》
CAS
2012年第6期48-51,共4页
Journal of Baotou Medical College
