人工关节置换术治疗高龄股骨粗隆间骨折42例分析

Treatment of femoral intertrochanteric fracture in 42 elderly patients with hip prosthetic replacement

目的探讨人工髋关节置换术治疗高龄股骨粗隆间骨折的临床疗效。方法收集该院自2006年5月至2011年12月收治75岁以上不稳定型股骨粗隆间骨折42例行人工关节置换术,男17例,女25例,其中人工股骨头置换术13例,全髋关节置换术29例。骨折按Evans分型,Ⅲ型2l例,Ⅳ型12例,Ⅴ型9例。记录手术时间,术中出血量。对获得随访的42例临床资料进行回顾性分析,采用Harris评分对治疗效果进行评定。结果 42例患者都顺利通过手术,手术时间57～102min,术中出血量约210～620mL。术后均获随访,随访时间为16～60个月,平均33个月。按Harris评分,优11例,良25例,可5例,差1例;优良率85.7%。结论人工关节置换术治疗高龄股骨粗隆间骨折,可减少卧床时间,早期下地行走。是治疗不稳定型高龄股骨粗隆间骨折患者比较安全、有效的手术方式。

Objective To discuss the clinical effect of hip prosthetic replacement in treating intertrochanteric fractures in senile patients.Methods Totally 42 senile patients(males 17 and females 25)with intertrochanteric fractures were treated by hip prosthetic replacement from May.2006 to Dec.2011.Femoral head replacement 13 cases,29 cases of total hip replacement.According to the evans classification of intertrochanteric fractures,there were 21 cases in type Ⅲ,12 cases in type Ⅳ and 9 cases in type Ⅴ.Recording the operation time,bleeding volum.A total of 42 patients were followed up,and its outcome was evaluated by Harris scoring system.Results Successful operation Was achieved in 42 patients.The operation time was 57-102 minutes,the intraoperative blood loss was about 210-620 mL.All patients were followed up for 16 to 60 months,averaging 33 months.According to Harris evaluation,11 cases were rated as excellent,25 good,5 fair,and 1 poor.The excellent and good rate was 85.7%.Conclusion Hip replacement in treating intertrochanteric fractures in senile patients shows a limited bleeding and operating time consumption.Can reduce the time in bed and early ambulation,the treatment of femoral intertrochanteric fracture in elderly patients with hip prosthetic replacement was safely and effectively.