骨水泥型半髋关节置换治疗高龄不稳定股骨粗隆间骨折

Treatment of Unstable Intertrochanteric Fractures in Elderly Patients with Cemented Bipolar Prosthetic Replacement

目的：探讨半髋关节置换治疗高龄不稳定股骨粗隆间骨折的疗效。方法：对24例高龄股骨粗隆间骨折患者行骨水泥型半髋关节置换术，X线片观察骨折愈合及假体情况，Harris髋关节评分评价疗效。结果：术后24例获平均为14个月（10～22个月）的随访，骨折愈合好，无假体脱位、松动等并发症。 Harris髋关节评分优15例，良7例，可2例。结论：对于高龄不稳定股骨粗隆间骨折，采用骨水泥型半髋关节置换治疗可以早期恢复肢体功能，早期下床负重，减少术后并发症，提高生活质量，是内固定治疗的很好补充，但要严格掌握手术适应证。

Objective：To study and evaluate results of the bipolar prosthetic replacement for the treatment of unstable intertrochanteric fractures in the elderly.Methods：From 2008 to 2012, twenty-four cases unstable intertrochanteric fractures in the elderly were treated with cemented bipolar prosthetic replacement.The healing of fracture and complication of prosthesis were observed with radiology after op-eration and the recovery of hip function with the evaluation system of Harris was evaluated.Results：Twenty-four cases were followed up for 10 to 22 months （ average time was 14 months） .Complete union was observed in all cases with no obvious complications of prosthetics as loosening and dislocation.Evaluation system of Harris was excellent for 15 cases,good for 7 cases, fair for 2 case.Conclusion： For elderly patients with unstable intertrochanteric fractures, cemeted bipolar prosthetic replacement may be the better choice than internal fix-ation in the advantage of earlier function recovery and low complications.But indications must be emphasized for this surgery.