中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
12期
1071-1075
,共5页
朱裕昌%孙业青%孙健%蔡新宇%蔡郑东
硃裕昌%孫業青%孫健%蔡新宇%蔡鄭東
주유창%손업청%손건%채신우%채정동
股骨骨折%骨折固定术,内%关节成形术,置换,髋
股骨骨摺%骨摺固定術,內%關節成形術,置換,髖
고골골절%골절고정술,내%관절성형술,치환,관
Femoral fractures%Fracture fixation,internal%Arthroplasty,replacement,hip
目的 分析人工关节置换治疗内固定失败的股骨转子间骨折的临床效果及手术技术. 方法 选择2001年- 2009年内固定治疗失败的股骨转子间骨折18例,动力髋螺钉(DHS)固定失败16例,股骨近端防旋螺钉(PFNA)固定失败2例.失败后对13例行人工双极股骨头置换,5例行全髋关节置换.Harris评分评估术后结果. 结果 12例获得完整随访,随访时间1～7年,平均2.3年.本组患者2例出现术中并发症；3例术后3个月内死亡,3例失访；l例出现关节脱位,闭合复位牵引治疗.患者疼痛均较术前明显减轻或消失,2例活动后有中度疼痛,4例活动后出现轻微疼痛.Harris评分术前平均34分,术后1年平均83分. 结论 人工关节置换能恢复髋关节功能,是治疗内固定失败的股骨转子间骨折的有效治疗方法.
目的 分析人工關節置換治療內固定失敗的股骨轉子間骨摺的臨床效果及手術技術. 方法 選擇2001年- 2009年內固定治療失敗的股骨轉子間骨摺18例,動力髖螺釘(DHS)固定失敗16例,股骨近耑防鏇螺釘(PFNA)固定失敗2例.失敗後對13例行人工雙極股骨頭置換,5例行全髖關節置換.Harris評分評估術後結果. 結果 12例穫得完整隨訪,隨訪時間1～7年,平均2.3年.本組患者2例齣現術中併髮癥；3例術後3箇月內死亡,3例失訪；l例齣現關節脫位,閉閤複位牽引治療.患者疼痛均較術前明顯減輕或消失,2例活動後有中度疼痛,4例活動後齣現輕微疼痛.Harris評分術前平均34分,術後1年平均83分. 結論 人工關節置換能恢複髖關節功能,是治療內固定失敗的股骨轉子間骨摺的有效治療方法.
목적 분석인공관절치환치료내고정실패적고골전자간골절적림상효과급수술기술. 방법 선택2001년- 2009년내고정치료실패적고골전자간골절18례,동력관라정(DHS)고정실패16례,고골근단방선라정(PFNA)고정실패2례.실패후대13례행인공쌍겁고골두치환,5례행전관관절치환.Harris평분평고술후결과. 결과 12례획득완정수방,수방시간1～7년,평균2.3년.본조환자2례출현술중병발증；3례술후3개월내사망,3례실방；l례출현관절탈위,폐합복위견인치료.환자동통균교술전명현감경혹소실,2례활동후유중도동통,4례활동후출현경미동통.Harris평분술전평균34분,술후1년평균83분. 결론 인공관절치환능회복관관절공능,시치료내고정실패적고골전자간골절적유효치료방법.
Objective To evaluate the surgical procedures and clinical efficacy of endoprosthetic replacement as a salvage procedure for intertrochanteric fracture suffered failure of internal fixation.Methods The study involved 18 intertrochanteric fracture patients that suffered failed internal fixation from 2001 to 2009,including 16 patients with failed dynamic hip screw (DHS) fixation and two with failed proximal femoral nail anti-rotation (PFNA).The patients were at mean age of 76.5 years (range,58-92 years).The treatment methods included total hip arthroplasty in five patients and the bipolar hemiarthroplasty in 13.Harris score was used to evaluate the function outcome during the follow-up.Results The mean operation time lasted for 115 minutes,with intraoperative blood loss of 500 ml.Two patients presented with intraoperative complications.Of all the patients,three patients died within three months after operation and three patients were lost to follow-up.The remaining 12 patients received complete follow-up for a mean of 2.3 years ( range,1-7 years).One patient with hip joint dislocation was treated with closed reduction and distraction for three weeks.At the latest follow-up,the pain disappeared or was reduced in all the patients,including two patients with moderate pain and four with mild pain after some movements.The average Harris score was increased from preoperative 34 points to 83 points at one year after operation.Conclusions Endoprosthetic replacement is an effective salvage procedure for the failed treatment of the intertrochanteric fracture,as it can attain satisfactory pain relief and functional improvement.
