加长柄水泥人工髋关节置换结合粗隆间重建治疗高龄股骨粗隆间骨折

Long-stem cemented artificial hip replacement combined with intertrochanteric reconstruction for the treatment of femoral intertrochanteric fractures in the elderly

目的探讨加长柄水泥人工髋关节置换结合粗隆间重建治疗高龄股骨粗隆间骨折的临床疗效。方法分析自2012至2020年使用加长柄水泥人工髋关节置换结合粗隆间重建治疗高龄股骨粗隆间骨折治疗效果及其术后康复情况,患者临床资料68例患者,其中男28例,女40例,年龄70~96岁,平均81.6岁,左侧36例,右侧32例,其中新鲜骨折60例,陈旧性骨折8例,致伤原因,其中车祸伤18例,自行摔伤50例,均为股骨粗隆间粉碎性骨折;Evans-JensenⅢ型32例,Ⅳ型36例术后按Harris评分标准进行随访评价。结果本组术后下床活动时间平均3.5 d(3~14 d)。平均随访20.4个月(10~36个月),除1例感染外,未发现假体松动、下沉。术后根据Harris髋关节评分本组病例中优54例,良8例,中6例,优良率为91.2%(62/68)。结论加长柄水泥人工髋关节置换结合粗隆间重建治疗高龄股骨粗隆间骨折是一种较好的治疗手段。

Objective To investigate the clinical effect of extended-steel cemented artificial hip replacement combined with intertrochanteric reconstruction in the treatment of elderly femoral intertrochanteric fractures.Methods From 2012 to 2020,the clinical data of 68 patients,including 28 males and 40 females,aged 70-96 years,with an average age of 81.6 years,36 on the left and 32 on the right,including 60 fresh fractures,8 old fractures,and the cause of injury,including 18 traffic accidents and 50 spontaneous falls,were analyzed.All were comminuted intertrochanteric fractures of the femur.Evans-Jensen typeⅢin 32 cases and typeⅣin 36 cases were followed up and evaluated according to the Harris scoring standard.Results The average time to get out of bed after operation in this group was 3.5 days(3-14 days).The average follow-up was 20.4 months(10-36 months),except for one case of infection,no prosthesis loosening or subsidence was found.According to Harris hip score after operation,in this group,effectiveness was excellent in 54 cases,good in 8 cases,and moderate in 6 cases.The excellent and good rate was 91.2%(62/68).Conclusion Cemented hip arthroplasty with extended stem combined with intertrochanteric reconstruction is a good treatment for elderly femoral intertrochanteric fractures.