中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
10期
909-912
,共4页
曹杨%刘斌%王大为%幺贵军%毕郑钢
曹楊%劉斌%王大為%幺貴軍%畢鄭鋼
조양%류빈%왕대위%요귀군%필정강
股骨骨折,高龄%关节成形术,置换%股骨转子间骨折
股骨骨摺,高齡%關節成形術,置換%股骨轉子間骨摺
고골골절,고령%관절성형술,치환%고골전자간골절
Femoral fractures,aged%Arthroplasty,replacement%Hip intertrochanteric fractures
目的 探讨双极人工股骨头置换术治疗骨质疏松性不稳定性股骨转子间骨折的疗效.方法 选择我院2003年4月-2010年1月应用双极人工股骨头置换术治疗75岁以上股骨转子间骨折患者53例.骨折类型按Evans-Jenson分型:Ⅲ型24例,Ⅳ型18例,Ⅴ型11例.Singh 指数Ⅰ级13例,Ⅱ级18例,Ⅲ级12例,Ⅳ级10例.多数患者伤后3d内手术.结果 手术时间(75±10)min,出血量(350 +68)ml.3例出院后失访,1例于术后5个月死于慢性支气管炎呼吸功能衰竭.术后共49例获得随访,随访时间12～93个月,平均38个月.未发现关节脱位,人工假体松动、下沉或断裂.根据Harris髋关节功能判定标准,末次随访时优29例,良13例,中7例,优良率为86％.结论 应用人工关节置换治疗骨质疏松性不稳定性股骨转子间骨折是一种有效的治疗方法.但其创伤较大,作为内固定治疗股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)的补充,需要严格掌握其适应证.
目的 探討雙極人工股骨頭置換術治療骨質疏鬆性不穩定性股骨轉子間骨摺的療效.方法 選擇我院2003年4月-2010年1月應用雙極人工股骨頭置換術治療75歲以上股骨轉子間骨摺患者53例.骨摺類型按Evans-Jenson分型:Ⅲ型24例,Ⅳ型18例,Ⅴ型11例.Singh 指數Ⅰ級13例,Ⅱ級18例,Ⅲ級12例,Ⅳ級10例.多數患者傷後3d內手術.結果 手術時間(75±10)min,齣血量(350 +68)ml.3例齣院後失訪,1例于術後5箇月死于慢性支氣管炎呼吸功能衰竭.術後共49例穫得隨訪,隨訪時間12～93箇月,平均38箇月.未髮現關節脫位,人工假體鬆動、下沉或斷裂.根據Harris髖關節功能判定標準,末次隨訪時優29例,良13例,中7例,優良率為86％.結論 應用人工關節置換治療骨質疏鬆性不穩定性股骨轉子間骨摺是一種有效的治療方法.但其創傷較大,作為內固定治療股骨近耑防鏇髓內釘(proximal femoral nail antirotation,PFNA)的補充,需要嚴格掌握其適應證.
목적 탐토쌍겁인공고골두치환술치료골질소송성불은정성고골전자간골절적료효.방법 선택아원2003년4월-2010년1월응용쌍겁인공고골두치환술치료75세이상고골전자간골절환자53례.골절류형안Evans-Jenson분형:Ⅲ형24례,Ⅳ형18례,Ⅴ형11례.Singh 지수Ⅰ급13례,Ⅱ급18례,Ⅲ급12례,Ⅳ급10례.다수환자상후3d내수술.결과 수술시간(75±10)min,출혈량(350 +68)ml.3례출원후실방,1례우술후5개월사우만성지기관염호흡공능쇠갈.술후공49례획득수방,수방시간12～93개월,평균38개월.미발현관절탈위,인공가체송동、하침혹단렬.근거Harris관관절공능판정표준,말차수방시우29례,량13례,중7례,우량솔위86％.결론 응용인공관절치환치료골질소송성불은정성고골전자간골절시일충유효적치료방법.단기창상교대,작위내고정치료고골근단방선수내정(proximal femoral nail antirotation,PFNA)적보충,수요엄격장악기괄응증.
Objective To explore the application and clinical effect of bipolar hemiarthroplasty with bipolar prosthesis on unstable intertrochanteric fracture in the elderly patients.Methods The study involved 53 patients aged over 75 years with intertrochanteric fracture treated with bipolar hemiarthroplasty in our hospital from April 2003 to January 2010.According to Evans-Jensen classification,there were 24 patients with type Ⅲ fractures,eight with type Ⅳ and 11 with type Ⅴ.Osteoporosis degree was at Singh degree Ⅰ in 13 patients,degreeⅡ in 18,degree Ⅲ in 12 and degree Ⅳ in 10.Most patients underwent operation within three days after injury.Results The operation duration was(75 ±10)min,with intraoperative blood loss of(350 ± 68)ml.Three patients were lost to follow-up after discharge and one patient was died of respiratory failure caused by chronic bronchitis five months after operation.Forty-nine patients were followed up for 12-93 months(mean 38 months),which showed no joint dislocation,or loosening,subsidence or rupture of the prosthesis.According to the Harris score of hip joint,the result at final follow-up was excellent in 29 patients,good in 13 and fair in seven,with excellence rate of 86％.Conclusions Bipolar hemiarthroplasty is an effective treatment for osteoporotic and unstable intertrochanteric fractures in the elderly patients.However,as the complemented therapeutic method of proximal femoral nail antirotation(PFNA),bipolar hemiarthroplasty has severe secondary trauma and its indications must be strictly mastered.
