人工关节置换联合有限内固定治疗老年人股骨转子间骨折

Artificial joint replacement combined with limited internal fixation in treating elderly patients with intertrochanteric fractures

目的:探讨人工关节置换联合有限内固定治疗老年人转子间骨折的临床效果。方法:选取2012-01-2015-12我科老年人股骨转子间骨折48例,所有患者均采用人工关节置换联合有限内固定的方法治疗,观察、记录其手术时间、出血量、下床时间、住院时间、术后并发症及髋关节功能情况。结果:所有患者均成功完成手术,手术时间为60~90min,平均手术时间为75min;术中失血为300~500ml,平均失血400ml;患者下地时间为2~5d,平均下床负重时间为3d;住院时间为7~21d,平均住院时间为14d;其中40例患者获得随访,无患者出现伤口感染、肺部感染、褥疮,仅2例患者出现顽固性疼痛,无患者出现假体松动、脱位,未出现二次骨折。所有患者均能正常行走,其术后髋关节功能Harris评分平均值为88分,其中20例为优(>90分),15例为良(80~89分),3例为中(70~79分),2例为差(<70分)。结论:人工髋关节置换联合有限内固定是治疗老年人股骨转子间骨折的有效方法,具有获得良好的髋关节功能,促进患者早期下床,降低并发症等特点。

Objective：To discuss the effect of artificial joint replacement combined with limited internal fixation for the treatment of intertrochanteric fractures in the elderly.Method：Forty-eight elderly patients with interthochanteric fractures in our department were chosen between January 2012 and December 2015.All patients were treated with artificial joint replacement combined with limited internal fixation.Observe and record the time of operation,the amount of bleeding,out-of-bed time,hospital stays,postoperative complications and hip function.Result：All patients were completed the operation successfully with an operating time of 60~90min and the average was 75min;The blood loss was 300~500ml and the average was 400ml;The out-of-bed time was 2~5days and the average was 3days;The hospital stays was 7~21days and the average was 14 days.Forty patients received follow-up,no patients appeared wound infection,pulmonary infection,bedsore,only two patients suffered from intractable pain,no patients appeared prosthesis loosening and dislocation and no secondary fractures happened.All patients were able to walk normally,the average Harris score of postoperative hip function was 88,of which 20 were excellent（〉90）,15 were good（80~89）,3were medium（70~79）,and 2were poor（〈70）.Conclusion：Artificial hip joint replacement combined with limited internal fixation is an effective method for treating intertrochanteric fractures in the elderly,which can make patients get good hip function,promote patients get out of bed early and reduce complications and so on.