摘要
目的探讨高龄患者转子间骨折行骨水泥型人工关节置换的手术方法与疗效。方法采用标准双动人工股骨头全髋或半髋关节置换术治疗股骨转子间骨折23例，其中全髋9例，半髋14例。骨折按Evans分型：EvansⅡ型8例，Ⅲ型15例，其中男13例，女10例，年龄67～91岁，平均79．5岁。手术过程中保留股骨距，争取将大、小转子骨折块复位、张力带钢丝固定。结果术后随访7～22个月，平均18．4个月，随访期间未见假体松动及髋臼磨损，无其他严重并发症。手术疗效评价按Harris评分，最低76分，最高93分，平均81．5分。结论骨水泥型人工关节置换术具有允许术后早期完全负重活动、并发症发生率低和功能恢复满意等优点，是治疗高龄不稳定型股骨转子间骨折的较合理的手术方法。
Objective To approach the method and the therapeutic effect of hemiarthroplasty or arthroplasty with hone cement for unstable intertrochanteric hip fracture in senile patients. Methods There were 23 senile patiens, suffering from the unstable intertrochanteric hip fracture,incluing 8 Evans Ⅱ patients and 15 Evans Ⅲ patients. The patients were treated with hemiarthroplasty or arthroplasty from September 2002 to December 2007,13 were males and 10 were females, aged 67 to 91 years, average 79.5 years. The typical ambi-touching artificial thigh bone was used in all patients,incluing 9 arthroplasty and 14 hemiarthroplasty. The calcar femorale was reserved,and the fractuer of trochiter or entotrochanter of femur got reduce and wire lock. Results The pa- tients were followed up for 7 to 22 months,average 18.4 months. No cinch or wearing happened, and no other serious complications happened. The Harris score was use to evaluate the therapeutic effect,which was 76 to 95,average 87.5. Twelve cases got excellent,whose score was in 90-100,8 were fine whose score in 80-89 and 3 were general,whose score in 70-79. Conclusion Because of many virtues,such as earlier period activity out of bed,low incidence of complications, satisfaction of functional recovery, the prosthetic replacement with bone cement is a reasonable preference for unstable intertrochanteric hip fracture in senile patients, and the key point is to master the indication and rational operation.
出处
《重庆医学》
CAS
CSCD
北大核心
2009年第1期60-61,共2页
Chongqing medicine
