摘要
背景:高龄不稳定型股骨转子间骨折因一般情况差,骨质条件差,如予骨折内固定,一方面可能导致骨折不愈合,另一方面治疗后仍需较长时间卧床、髋关节固定从而导致长期卧床并发症,而人工股骨头置换是一种安全的修复方式,可较早解决患者早期下床活动问题。目的:观察人工双极股骨头置换对高龄不稳定型股骨转子间骨折的修复效果。方法:选择2005至2014年解放军第101医院骨科收治的高龄不稳定型股骨转子间骨折患者39例,男21例,女18例;年龄80-96岁,平均85岁,均进行双极人工股骨头置换。测定置换后1年髋关节功能Harris评分以评估疗效,并记录并发症发生情况。结果与结论:39例患者均获得随访,随访时间1-5年。所有患者伤口均一期愈合,无各种心脑血管意外,均安全渡过围术期,无严重并发症发生。置换后1年髋关节功能按Harris评分法进行评估:优13例,良20例,可4例,差2例,优良率85%,均无脱位并发症发生。提示人工双极股骨头置换修复高龄不稳定型股骨转子间骨折,置换后卧床时间短、出血少、并发症少、髋关节功能恢复良好。对于高龄不稳定型股骨转子间骨折患者,人工双极股骨头置换是一种安全、有效的理想修复方式。
BACKGROUND：In elderly patients with unstable intertrochanteric fracture,because of poor general condition and poor bone condition,on one hand,the internal fixation of fracture may lead to nonunion.On the other hand,patients still need longer time in bed and hip joint fixation,and may result in complications of long-term bed rest.Artificial femoral head replacement is a safe operation mode,can solve the problem of early ambulation of patients.OBJECTIVE：To observe the repair effect of bipolar artificial femoral head replacement on unstable femoral intertrochanteric fracture in elderly patients.METHODS：A total of 39 elderly patients with unstable femoral intertrochanteric fractures,who were treated in the Department of Orthopedics,101 Hospital of Chinese PLA from 2005 to 2014,were enrolled in this study.There were 21 males and 18 females,at the age of 80-96 years old,averagely 85 years old.They all received bipolar artificial femoral head replacement.Harris score was measured to assess hip joint function at 1 year after replacement.The incidence of complications was recorded.RESULTS AND CONCLUSION：A total of 39 cases were followed up for 1-5 years.The wound of all patients was healed in the primary stage.No cardiovascular or cerebrovascular accident appeared.All patients passed safely through the perioperative period.No severe complications occurred.Hip joint function was assessed according to Harris score at 1 year after replacement：excellent in 13 cases,good in 20 cases,average in 4 cases,poor in 2cases,with an excellent and good rate of 85%.No dislocation appeared.The results suggest thatbipolar artificial femoral head replacement can be used to treat femoral intertrochanteric fracture in elderly patients.The postoperative recovery time was short; bleeding was less; complications were few.Hip joint function recovered well.For elderly patients with femoral intertrochanteric fracture,bipolar artificial femoral head replacement is an ideal safe effective repair method.
出处
《中国组织工程研究》
CAS
北大核心
2015年第26期4118-4122,共5页
Chinese Journal of Tissue Engineering Research
