全髋关节置换术治疗髋部骨折内固定失败患者35例

Total Hip Arthroplasty in the Treatment of 35 Cases of Failed Hip Fracture Internal Fixation

目的探讨髋部骨折内固定失败后应用挽救性全髋关节置换术的临床疗效。方法选取2008年9月至2013年4月我院收治的35例髋部骨折(具体指股骨颈骨折、股骨转子间骨折,不包括髋臼骨折)复位内固定失败患者,回顾性分析其临床资料,均再行全髋关节置换术治疗,观察患者的术后疗效、并发症发生情况。结果所有患者均顺利完成置换术,手术时间为(2.5±0.7)h,住院时间为(12.8±4.3)d,卧床时间为(7.2±1.6)d。术后的活动度评分、功能评分、行走评分、疼痛评分、Harris评分均显著高于术前(P<0.05)。未出现重大并发症,术后脱位2例,复位后予外展支具固定6周后稳定。结论应用全髋关节置换术治疗髋部骨折内固定失败患者,疗效确切,安全性高,可改善髋关节功能,利于患者康复。

Objective To explore the clinical efficacy of salvage total hip replacement for the treatment of patients with failed hip fracture internal fixation. Methods The clinical data of 35 cases of hip fracture patients who failed in hip fracture internal fixation in our hospital from September 2008 to April 2013 were analyzed retrospectively. All patients received salvage total hip replacement. The curative effect and postoperative complications were observed. Results All patients had successful completion of arthroplasty, with the operation time of（2.5 ± 0.7） h, length of hospital stay of（12.8 ± 4.3） d, and bed rest time of（7.2 ± 1.6） d. The activity score, function score, walking score, pain score and Harris score after operation were significantly higher than those before operation（P〈0.05）. No serious complication was found; 2 cases had postoperative dislocation, and both were stable after reduction and abduction brace fixation. Conclusions Total hip replacement for the treatment of patients with failed hip fracture internal fixation has exact efficacy, and high safety. It can improve the hip joint function, and conducive to the rehabilitation.