加长柄骨水泥型双极人工股骨头置换治疗老年不稳定股骨粗隆间骨折

Cemented bipolar artificial femoral head replacement for the treatment of unstable intertrochanteric fractures in elderly patients

目的探讨加长柄骨水泥型双极股骨头置换治疗老年不稳定股骨粗隆间骨折的临床疗效。方法回顾性分析15例老年不稳定股骨粗隆间骨折患者采用加长柄骨水泥型双极股骨头置换治疗的临床情况。结果本组手术时间90 min^135 min,15例均获随访,时间6个月~42个月。术后发生老年应激性精神障碍2例,低钠低钾血症2例,对症处理恢复正常。双下肢不等长1例,跛行步态,行走疼痛,2个月后缓解,无假体脱位、下沉、松动、感染、深静脉血栓形成等并发症,3 d^10 d下地扶助行器部分负重行走。Harris髋关节功能评分:优7例,良6例,可1例,差1例,优良率86.7%。结论加长柄骨水泥型双极股骨头置换治疗老年不稳定股骨粗隆间骨折,具有损伤较小,下地时间早,并发症少的优点,可明显改善患者的生活质量,近期疗效满意。

Objective Toinvestigatetheclinical effect of longstemcemented bipolar femoral head replacement in the treatment of unstable intertrochanteric fractures in elderly patients.Methods 15 cases of unstable intertrochanteric fractures were treated with extended stem cemented bipolar femoral head replacement.Results The operation time was 90 min^135 min,15 cases were followed up for 6-42 months.There were 2 cases of stress- induced mental disorders and 2 cases of low sodium and low potassium in the elderly.Complications of double limb length in 1 case,limpinggait,walking pain,relieved after 2 months,no prosthesis dislocation subsidence or loosening,infection,deep vein thrombosisformation.3 d^10 d assistanceis part of weight-bearingwalking.The Harris hip score： excellent in 7 cases,good in 6 cases,1 cases,1 cases of poor,good rate of 86.7%.Conclusion long stem cemented bipolar femoral head replacement in treatment of elderly patients with unstable intertrochanteric fractures,with little damage to early time,fewer complications,significantly improvethequality of life,curativeeffect.