摘要
[目的]探讨保留粗隆部的普通股骨假体置换术治疗老年粗隆部不稳定骨折的方法及临床效果。[方法]采用保留粗隆部的普通股骨假体置换术治疗老年粗隆部不稳定骨折15例,Evans分类:ⅢA2例,ⅢB4例,Ⅳ8例,逆粗隆骨折1例;所有病例均合并有内科系统疾病。[结果]本组无1例死亡,14例顺利出院,1例因呼吸系统并发症转内科治疗,1个月后出院。1例于术后出现下肢深静脉血栓形成(DVT),经治疗痊愈。术后X线片显示假体位置均良好,骨折复位满意。随访14～27个月,无假体松动、下沉及骨折不愈合。髋关节功能Harris评分平均为91分,优12例,良2例,可1例,优良率为93.3%。[结论]保留粗隆部的普通股骨假体置换术治疗老年粗隆部不稳定骨折,患者卧床时间短,并发症少,安全可靠,术后髋关节功能恢复良好,是治疗老年粗隆部不稳定骨折较为理想的方法。
[Objective] To study the method and outcome of normal prosthetic replacement with retained trochanter in treating unstable intertrochanteric fractures of the elderly patients. [Method] Fifteen patients with unstable intertrochanteric fractures aged 69 ～ 88 years were treated by normal prosthetic replacement with retained trochanter. According to the Evans classification, there were type Ⅲ A in 2 cases, Ⅲ B in 4 cases, IV in 8 cases, and reverse intertrochanteric fracture in 1 case. [Result] No patient died in all the 15 cases, 14 cases were discharged from the hospital smoothly, 1 case with respiratory disease was given relevant medical treatment and was discharged from the hospital after 1 month. Deep veinous thrombosis in 1 case was found in another case after surgery and resumed healthy after treatment. X -ray showed the prostheses were replaced well and the fractures were reduced satisfactorily in all cases. Fifteen cases were followed up for 14-27 months, no loosening of protheses and nonunion was observed. The hip joint function recovered satisfactorily, Harris score reached average 91, excellent results were achieved in 12 cases, good results in 2, and fair results in 1, the final satisfactory rate of being excellent and good was 93.3%. [ Conclusion] The satisfactory outcome of unstable intertrochanteric fractures of the elderly patients may obtain normal prosthetic replacement with retained trochanter, this technique is safe and satisfactory for the functional recovery of the hio ioint.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第20期1548-1550,共3页
Orthopedic Journal of China
