高龄转子间骨折患者全髋关节置换术效果的综合评价

Comprehensive evaluation of effect on total hip replacement for the management of intertrochanteric fracture in the elderly and the rehabilitation

目的:综合评价全髋关节置换手术对80岁以上转子间骨折患者的治疗及其术后康复过程。方法:80～100岁转子间骨折患者13例,平均86.6岁,均采用一期人工全髋关节置换手术进行治疗。结果:手术时间40～55min,平均45min。除1例术前有呼吸衰竭患者于术后17d死亡外,其余12例患者均于术后1周内在协助下练习不受限制地负重行走,并较顺利地恢复伤前功能水平。术后并发症主要为尿潴留或伴有充溢性尿失禁、电解质代谢紊乱、血糖增高、少尿及氮质血症,无一例卧床并发症及全髋关节置换特异并发症发生。结论:人工全髋关节置换手术是治疗高龄转子间骨折患者的一个安全有效的办法,术后康复快,可早期负重,避免卧床并发症,人工关节在高龄转子间骨折患者中的治疗地位有待认可。

AIM:To evaluate the curative effects of t ot al hip replacement for the man-agement of intertrochanteric fractures in patients aged 80and the elder.METHODS:Thirteen intertrochanteric fractu re patients aged from 80-100(a mean age of 86.6)were treated with primary total hip r eplacement.RESULTS:The operation for each hip lasted 40-55minutes w ith the av-erage time of 45minutes.Although th e postoperative rehabilitatio n was hard for the patients because of the muscu lar weakness,all patients but one co uld take unrestricted weight-bearing a nd were ambulating within one wee k af ter the replacement,and function was re stored within a short period of ti me.The patients who had preoperatively respiratory failure died 17days postop era-tively.There were no specific compl ications from bed rest and total hip r e-placement.The common postoperativ e complications were incontinence a nd r etention of urine,electrolytic di sorder,hyperglycemia,hypernitre mia and hyp ourocrinia.Total hip replacement for intertroc hanteric fractures i n el-derly is reasonably safe and is a suitable treatment because the prosthesi s provides for early weight-bearing a nd rapid rehabilitation,with this method bed resting complications