摘要
选择2004-08/2008-04海南省人民医院骨病外科收治的股骨转子间骨折患者48例,男20例,女28例;年龄70～93岁。全部为行走跌倒致伤,骨折类型按Evans分类:Ⅱ型18例,Ⅲ型10例,Ⅳ型18例,Ⅴ型2例,均为不稳定性骨折。全部患者均采用双极人工股骨头置换,置换前患髋Harris评分为差。记录置换时间,置换过程中出血量,Harris评分及围置换期并发症。48例患者中42例获得随访,6例失访。置换时间50～88min,平均78.5min。42例患髋均无明显疼痛,无髋关节脱位和假体松动,再骨折等,置换后并发下肢深静脉血栓4例,一过性精神障碍3例,肠道菌群失调3例,6例双下肢不等长,髋臼磨损2例。置换后1年Harris评分优22例,良18例,优良率达83.3%。置换后1周开始扶拐或在助行器帮助下下地行走,3周后基本能弃拐行走,置换过程中输血200～1400mL,平均600mL,伤口均Ⅰ期愈合。提示对于高龄股骨转子间骨折选择双极人工股骨头置换疗效可靠,但应注意预防并发症的发生。
Forty-eight patients with intertrochanteric fractures were selected from Department of Orthopedics, People＇s Hospital of Hainan Province from August 2004 to April 2008 including 20 males and 28 females aged 70-93 years. All fractures （unstable fracture） were caused by falling down in walking. There was type Ⅱ fracture in 18 cases, type Ⅲ in 10, type Ⅳ in 18 and type V in 2 according to the Evans classification. They were treated by bipolar femoral head replacement. The Harris score was poor preoperatively. Replacement time, blood loss, Harris scores and complications were recorded. Forty-two of 48 cases were followed up with 6 lost. Replacement lasted for 78.5 minutes （range 50-88 minutes）. No obvious pain, loosening or dislocation of the hip joints was found in 42 cases. Four cases sustained deep venous thrombosis of lower limbs; there were bilateral discrepancies of the lower extremities in 6 cases, acetabular wearing in 2 cases, acute mental dysfunction in 3 and dysbacteria in 3 cases. There was excellent in 22 cases and good in 18 cases based on the Harris score one year postoperatively. The overall excellent and good rate was 83.3%. The patients could walk with the help of stick or walking aid one week after surgery, and walk normally 3 weeks after replacement. Blood transfusion was 600 mL （range 200-1 400 mL） during replacement. The injury healed at primary stage. The bipolar femoral head replacement is effective and reliable in treating the intertrochanteric fracture in the senile patients. But it needs more attention on the prevention of complications.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第4期774-777,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
