人工股骨头置换术治疗偏瘫侧股骨颈骨折分析

Advantages and disadvantages of the hemiarthroplasty on the femoral neck fractures of the hemiplegic lower extremity

目的探讨采用骨水泥型人工股骨头置换术治疗偏瘫下肢股骨颈骨折的利弊。方法对接受人工股骨头置换的14例偏瘫下肢股骨颈骨折病例进行回顾性分析。结果全部病例均得到随访,时间最短18个月,最长10年,术后发生非中心性关节脱位5例,其中2例反复脱位;下肢深静脉血栓(DVT)5例;假肢松动3例;伤前能行走的13例病人术后有8例伤肢功能较伤前差。结论①偏瘫下肢伤前肌力越好,术后效果越佳,反之越差;②偏瘫侧股骨颈骨折采用人工股骨头置换术治疗,优点明显,但并发症多见,风险高。

Objective To explore advantages and disadvantages of the treatment on the femoral neck fractures of the hemiplegic lower extremity with the bone cement prosthesis. Methods 14 cases of the femoral neck fractures of the hemiplegic lower extremity treated by hemiarthroplasty were reviewed. Results All the cases were followed up, the following-up time was from 6 months to 10 years. 5 cases had dislocations (not pelvic central protrusion), 2 cases of the above five had recurrent dislocations; 5 cases had deep venous thrombosis(DVT); 2 cases had femoral fractures away from the distal of the prosthesis; 3 cases had heterotopic ossification; 1 case died of corpulmonale; 3 cases had loosening of the prosthesis; 8 of the 13 cases which could walk before the fractures had worse function than before the injury. Conclusion ①The better the muscular force of the hemiplegic lower limb was,the better the post-operative effect was. ②Hemiarthroplasty to the femoral neck fractures of the hemoplegic lower extremity has apparrent advantages, but also has more complications.