3种假体置换术治疗老年性股骨颈骨折的比较

Observative effects treatment of femoral neck by three types of artbroplasty in the elderly

目的 比较不同种类假体骨换对老年人股骨颈骨的治疗效果。方法 自 1988- 0 1对 5 0 9例 60岁以上老年股颈骨折分别采用单极股骨头 ,双极股骨头及全髋关节置换术。结果 5 0 9例术后 2～ 4周均恢复行走活动 ,死亡 2例。 4 0 2例获 1 5～ 7年随访 ,满意率 (6～ 2 4级 ) ,单极头 90 6% ,双极头 96 77% ,全髋95 %。 4 0 2例X线片检查 ,髋臼完好 2 60例 ,髋臼外缘增生 92例 ,髋臼磨损人工股骨头中心脱位 1例。由于外伤髋臼脱落 1例 ,假体柄下沉 >2mm8例 ,假体透光区 >2mm4 0例。结论 本组资料表明 3种类型假体置换无明显差异。因此对于高龄及活动量不大不强求全髋关节置换 。

Objective To compare curative effects of differenttpes of replacement with prosthesis,used to treat thighbone and neck-bone of old persons.Methods In January 1988,to perform operations on replacing single-pole thighbone,double-pole thighbone and all hip joint for thigh-and neck-bone fracture of 509 cases aged more than 60 years.Results After operation within 2-4 weeks,all 509 cases had recovered ability to walk and act,two cases died.Of them 402 cases,visited within 1.5-7 years after operation,got satisfaction ratio(class 6-24).Single pole bone case constitutes 90.6%,double pole case 96.77%,all hip joint case 95%.402 cases inspected by X-ray,of them,260 cases have perfect acetabular bone,92 cases have hyperplasia of acetabular bone outer edge and one case has acetabular bone abrasion and artificial thighbone center dislocation.Due to injury,one case has acetabular bone dropped,8 cases have prosthesis handle subsided by>2mm,and 40 cases have prosthesis photo-permeable space>2mm.Conclusion The data indicates that three types of prosthesis replacement have no remarkable difference.So,for the cases with advanced age,with not big active volume and not insisting on all hip-joint replacement,the replacement with artificial thighbone,especially doublepole bone,can also achieve the curative effect expected..