摘要
目的评估应用双动人工股骨头置换治疗高龄不稳定性股骨转子间骨折的疗效。方法回顾性分析2003年1月至2009年1月应用双动人工股骨头置换治疗高龄不稳定性股骨转子间骨折患者29例,男12例,女17例;平均年龄83.5岁(78～89岁)。均为新鲜骨折。EvansⅢ型11例,Ⅳ型18例。所有患者均有严重的骨质疏松和其他内科疾病。术后随访8～56个月,平均28.4个月。采用Harris评分评价关节功能、活动能力。术后2周内、3～6个月、1年拍患髋X线片,检查假体有无松动迹象。结果平均住院23 d,平均手术时间95 min,平均出血量310 mL,无一例死于术中及术后并发症。20例术后7～10 d下床负重行走,9例21 d后开始负重,平均13.5 d。Harris评分,优9例,良14例,中5例,差1例,总优良率79.3%。术后X线片检查未见假体松动下沉现象。结论应用双动骨水泥型人工股骨头置换治疗高龄不稳定性股骨转子间骨折患者是一种较好的方法,可早期下床活动,减少并发症,降低死亡率,提高生活质量。
objective To evaluate the clinical effect of treatment of unstable femoral intertrochanteric fractures with artificial femoral head replacement in the elderly patients. Methods From Jan 2003 to Jan 2009 there were 29 cases in the group,according to the classification of Evans ,there were 11 cases of type Ⅲ , 16 cases of type Ⅳ ,aged 78 -89 years with an average of 83.5years. All patients had some degree of osteoporosis and other function disordered. Follow-up study was performed in 29cases for 8 to 56 months（average 28.4 months）. The function of joint was evalu- ated with Harris score. Prothesis loosening was evaluated with X-ray. Results The average course of stay at hospital was 23 days. The mean duration, of operation was 95 minutes and blood loss was 310 mL. No patients died for opera- tive complication past operative. Weight-bearing walking began 7to 21 days after the operation （average 13.5 d）. No infection and loosening was found. According to Harris evaluation 9 cases were rated as excellent,14 good,5 fair,and 1 poor. A total of 79.3% of the patients had their joint function returned to normal or near normal, Conclusion It is an effective method to treat the unstable femoral intertrochanteric fracture with prosthetic replacement in elderly. Ar- tificial femoral head replacement may be the better choice than internal fixation in the adraneage of earlier functional recovery and lower complications.
出处
《实用骨科杂志》
2010年第2期93-95,共3页
Journal of Practical Orthopaedics
关键词
股骨转子间骨折
高龄
不稳定
关节置换
femur intertrochanteric fracture
elderly
unstable
joint replacement
