CAJ | 학술논문

目的探讨应用APL柄非骨水泥半髋关节置换术治疗老年不稳定性股骨转子间骨折的近期疗效.方法选择2008年7月至2011年12月实施APL柄人工半髋关节置换术治疗老年不稳定性股骨转子间骨折患者26例.男10例,女16例;年龄75～94岁,平均82.5岁.骨折分类按Evans-Jensen分型:Ⅱ型16例,Ⅲ型10例.结果手术时间48～72 min,平均56 min;术中出血240～600 ml,平均360ml.围手术期死亡患者1例,随访期间死亡患者2例.其余23例患者术后随访12～42个月,平均21.5个月.术后2～3周,患者可借助支具下床活动.术后3个月,21例患者平衡和行走能力已基本恢复至伤前水平,生活能自理.未出现髋臼磨损及股骨假体松动、下沉等手术相关并发症.脑梗死、下肢深静脉血栓各1例;泌尿系统感染2例;1例患者因长期应用激素,术后2年出现局部皮肤破溃;2例患者出现异位骨化.关节功能按Harris评价标准:优12例,良10例,可1例.结论应用APL柄非骨水泥固定半髋关节置换术治疗老年不稳定性股骨转子间骨折可以使患者摆脱因骨折愈合而卧床时间较长的困扰,早期下床活动,提高生活质量.
목적 탐토응용APL병비골수니반관관절치환술치료노년불은정성고골전자간골절적근기료효.방법 선택2008년7월지2011년12월실시APL병인공반관관절치환술치료노년불은정성고골전자간골절환자26례.남10례,녀16례;년령75～94세,평균82.5세.골절분류안Evans-Jensen분형:Ⅱ형16례,Ⅲ형10례.결과 수술시간48～72 min,평균56 min;술중출혈240～600 ml,평균360ml.위수술기사망환자1례,수방기간사망환자2례.기여23례환자술후수방12～42개월,평균21.5개월.술후2～3주,환자가차조지구하상활동.술후3개월,21례환자평형화행주능력이기본회복지상전수평,생활능자리.미출현관구마손급고골가체송동、하침등수술상관병발증.뇌경사、하지심정맥혈전각1례;비뇨계통감염2례;1례환자인장기응용격소,술후2년출현국부피부파궤;2례환자출현이위골화.관절공능안Harris평개표준:우12례,량10례,가1례.결론 응용APL병비골수니고정반관관절치환술치료노년불은정성고골전자간골절가이사환자파탈인골절유합이와상시간교장적곤우,조기하상활동,제고생활질량.
Objective To discuss the short-term outcomes of uncemented APL stem hip hemiarthroplasty for unstable intertrochanteric fracture in elderly patients.Methods From July 2008 to December 2011,26 cases of intertrochanteric fractures were treated by hemiarthroplasty using uncemented APL stem.There were 10 men and 16 women with a mean age of 82.5 years (range,75-94 years).According to EvansJensen classification system,16 cases were type Ⅱ fractures,the other 10 were type Ⅲ.Results The mean operation time was 56 min (range,48 to 72 min).The average blood loss during the operation was 360 ml (range,240-600 ml).One of the patients died in the perioperative period,2 died during the follow-up.The other 23 patients were followed up with an average of 21.5 months (range,12-42 months).The patients were encouraged to walk with aid about 2-3 weeks postoperatively.Three months after the operation,the walking ability were almost recovered to pre-injury level in 21 cases.The acetabular wear,the prosthetic loosening and subsidence were not found.The complications included 1 case of cerebral infarction,1 case of deep venous thrombosis,2 urinary infection,1 skin ulcer due to the long-term use of cortical steroid and 2 heterotopic ossifications.According to Harris hip score,12 cases were classified as excellent,10 cases as good and 1 case as fair.Conclusion Hemiarthroplasty using uncemented APL stem is an effective way to treat the unstable intertrochanteric fracture in elderly patients.The quality of life of the elderly patients can be improved due to early mobilization after the surgery.