半髋关节置换在老年股骨粗隆间骨折的应用

The Application of Hemiarthroplasty in Senior Patients with Intertrochanteric Fracture

目的:探讨半髋关节置换对于老年股骨粗隆间骨折Evans-Jensen分型Ⅱ～Ⅳ型的疗效及临床实用性。方法:就笔者所在医院2009-2012年老年股骨粗隆间骨折Evans-Jensen分型Ⅱ～Ⅳ型的患者74例采用半髋关节置换治疗。并观察其住院时间、术后行走负重时间、死亡率及并发症。术后1、3、6、12个月及以后每年随访,评价关节活动度、生存率等。结果:对74例患者术后随访,平均住院18d,术后5～7d均能扶助行器行走,术后21～24d能完全负重行走,未发现感染、松动、脱位者。手术1年后91.89%的患者髋关节功能恢复到受伤前水平。无死亡或术后并发症患者。随访期内无脱位等。结论:人工半髋关节置换对于老年股骨粗隆间骨折Evans-Jensen分型Ⅱ～Ⅳ型的患者具有优异的临床效果,值得临床推广。

Objective： To discuss the clinical effect and practicability of hemiarthroplasty on type II -IV of Evans-Jensen type of intertrochanteric fracture （ TEJIF ） .Method： 74 cases of TEJIF senior patients who were admitted into our hospital from 2009 to 2012 were treated with hemiarthroplasty therapy.The length of hospital stay, weight-bearing walking time, mortality and complication, in addition, foUow-up visit after 1, 3, 6, 12 months and subsequent years, joint movement degree and surival rate were observed.Result： Follow-up visit was conducted in 74 cases after surgery, the average time of hospital stay was 18 d, walk could be done by using walking aid 5-7 d after operation, fully weight-bearing walking recovered 21- 24 after operation.There were no infection; relaxtion, dislocation happened.91.89% patients were recovered to the level of pre-injury, and no death, complication and dislocation happened.Conclusion： Artificial hemiarthroplasty has an outstanding clinical effect on TEJIF patients, it worth to be promoted in clinical therapy.