人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折56例临床分析

Clinical analysis of artificial femoral head replacement in treatment of 56 cases of senile unstable intertrochanteric fracture

[背景]探讨人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折的临床疗效.[病例报告]回顾性分析应用人工股骨头置换术治疗的56例高龄不稳定型股骨粗隆间骨折患者的临床资料,其中男性20例,女性36例.骨折按照Evans-Jensen分类,Ⅲ型30例,Ⅳ型24例,Ⅴ型2例.采用Harris评分对治疗效果进行评定.56例患者均顺利施行手术,手术时间为56~82min,术中出血量为180~420mL.术后所有患者均获得随访,随访时间为6~32个月,平均16个月.Harris评分结果为优30例、良19例、可5例、差2例,优良率为87.5%.[讨论]应用人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折可缩短卧床时间,早期进行功能锻炼,减少并发症,是安全、有效的手术方式.

BACKGROUND To study the clinical effects of artificial femoral head replacement in the treatment of senile unstable intertrochanteric fracture.CASE REPORTS The clinical data of 56 senile patients（males 20 and females 36）with unstable intertrochanteric fractures treated by the artificial femoral head replacement were retrospectively analyzed.According to the Evans-Jensen classification of intertrochanteric fractures,there were 30 cases in typeⅢ,24 cases in typeⅣ and 2cases in typeⅤ,and its treatment outcome was evaluated by Harris scoring system.Successful operation was achieved in 56 patients,the operation time was 56-82 min,the intraoperative blood loss was about 180-420 mL.All patients after operation were followed up for 6to 32 months,averaging 16 months.According to Harris evaluation,30 cases were rated as excellent,19 as good,5as fair,and 2as poor,and the excellent and good rate was87.5%.DISCUSSION The treatment of unstable intertrochanteric fracture in senile patients with artificial femoral head replacement can shorten the time in bed,early function rehabilitation,reduce the complications,and is a safe and effective operation.