生物型加长柄髋关节置换治疗高龄不稳定型股骨转子间骨折

Cementless long-stem hip prosthetic replacement for elderly patients with unstable femoral intertrochanteric fracture

目的：探讨生物型加长柄人工髋关节置换治疗高龄不稳定型股骨转子间骨折的临床疗效。方法对51例高龄不稳定型股骨转子间骨折患者采用经髋关节外侧切口前方入路生物型加长柄人工髋关节置换治疗。结果患者均顺利完成手术,术后发生急性深静脉血栓2例,经积极治疗恢复正常。死亡2例,1例术后6个月死于心肌梗死,1例术后10个月死于肺部感染。49例获得随访,时间12-36个月。骨折愈合时间4-10个月,无人工关节脱位、假体周围感染、假体松动等并发症。术后12个月按Harris评分评定患髋关节功能：优18例,良25例,可5例,差1例,优良率87．8%。结论生物型加长柄人工髋关节置换是治疗高龄不稳定型股骨转子间骨折的一种安全有效方法。

Objective To investigate the clinical effect of cementless long-stem hip prosthetic replacement for elderly patients with unstable femoral intertrochanteric fractures. Methods Fifty-one cases with unstable femoral intertro-chanteric fractures were treated by cementless long-stem hip prosthetic replacement via hip joint lateral incision anteri-or approach. Results All patients were successfully operated, acute deep venous thrombosis occurred in 2 cases af-ter operation,they were returned to normal after symptomatic treatment. 2 patients died,1 patient died of myocardial infarction after 6 months,1 patient died of lung infection after 10 months. Forty-nine cases were followed up for 12 -36 months. The fracture healing time was 4-10 months after operation. There was no prosthetic dislocation, infec-tion, loosening and other complications. In 12 months postoperation, according to Harris rating scale：the clinical re-sult was evaluated as excellent in 18 cases, good in 25 cases, fair in 5 and poor in 1. The rate of excellent and good was 87. 8%. Conclusions It is a safe and effective technique to treat unstable femoral intertrochanteric fracture in elderly patients with cementless long-stem hip prosthetic replacement.