大理学院学报：综合版
大理學院學報：綜閤版
대이학원학보：종합판
Journal of Dali University
2012年
12期
47-49
,共3页
股骨粗隆骨折%加长柄人工股骨头置换%老年人
股骨粗隆骨摺%加長柄人工股骨頭置換%老年人
고골조륭골절%가장병인공고골두치환%노년인
intertrochanteric fractures%artificial long-stem femoral head replacement%elderly
目的：分析和评价加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折的方法及疗效。方法：本组15例，男10例，女5例；年龄70～90}0，平均79岁。骨折按Evans分类，ⅢA型9例，ⅢB型6例。取髋关节后外侧切口，术中注意保留股骨大、小转子部位的骨折块，用骨水泥固定，争取将其重新复位。由于股骨颈及股骨距骨缺损，在插入人工股骨柄之前可用试模测试。股骨距部位的骨缺损用骨水泥充填重塑，关节腔内置负压引流管48—72h。结果：15例患者均康复出院。住院时间16～24d，平均20d。均获得随访，平均随访时间8个月（6—12个月），伤口均一期愈合，无感染，无假体松动，无下肢深静脉栓塞发生，无髋关节脱位或半脱位发生，无病人死于手术并发症，12例病人髋关节功能满意。结论：加长柄人工股骨头置换术是治疗高龄股骨粗隆部不稳定骨折的可靠方法，其操作可行，疗效满意，可降低死亡率、改善生活质量。
目的：分析和評價加長柄人工股骨頭置換術治療高齡股骨粗隆部不穩定骨摺的方法及療效。方法：本組15例，男10例，女5例；年齡70～90}0，平均79歲。骨摺按Evans分類，ⅢA型9例，ⅢB型6例。取髖關節後外側切口，術中註意保留股骨大、小轉子部位的骨摺塊，用骨水泥固定，爭取將其重新複位。由于股骨頸及股骨距骨缺損，在插入人工股骨柄之前可用試模測試。股骨距部位的骨缺損用骨水泥充填重塑，關節腔內置負壓引流管48—72h。結果：15例患者均康複齣院。住院時間16～24d，平均20d。均穫得隨訪，平均隨訪時間8箇月（6—12箇月），傷口均一期愈閤，無感染，無假體鬆動，無下肢深靜脈栓塞髮生，無髖關節脫位或半脫位髮生，無病人死于手術併髮癥，12例病人髖關節功能滿意。結論：加長柄人工股骨頭置換術是治療高齡股骨粗隆部不穩定骨摺的可靠方法，其操作可行，療效滿意，可降低死亡率、改善生活質量。
목적：분석화평개가장병인공고골두치환술치료고령고골조륭부불은정골절적방법급료효。방법：본조15례，남10례，녀5례；년령70～90}0，평균79세。골절안Evans분류，ⅢA형9례，ⅢB형6례。취관관절후외측절구，술중주의보류고골대、소전자부위적골절괴，용골수니고정，쟁취장기중신복위。유우고골경급고골거골결손，재삽입인공고골병지전가용시모측시。고골거부위적골결손용골수니충전중소，관절강내치부압인류관48—72h。결과：15례환자균강복출원。주원시간16～24d，평균20d。균획득수방，평균수방시간8개월（6—12개월），상구균일기유합，무감염，무가체송동，무하지심정맥전새발생，무관관절탈위혹반탈위발생，무병인사우수술병발증，12례병인관관절공능만의。결론：가장병인공고골두치환술시치료고령고골조륭부불은정골절적가고방법，기조작가행，료효만의，가강저사망솔、개선생활질량。
Objective: To explore and evaluate the method of artificial long-stem femoral head replacement for the treatment of unstable intertroehanteric fractures of 15 elderly patients. Methods: Fifteen cases of elderly aged 70-90 years old (average 79 years old, 10 male and 5 female) were enrolled in study. Fractures were typed according to Evans classification: 9 cases of type 111 A, 6 cases of type m B. Applied the posterolateral hip incision, fractured fragments of large trochanter and minor trochanter should be preserved during the operations that the fragments could be fixed with bone cement. A model could be used before insertion of artificial femoral shaft because of the defects of femoral neck and femoral calcar. Bone defects in the femoral ealcar were stuffed with bone cement, suction drainage were maintained for 48-72 hours. Results: All fifteen patients were cured and discharged. The period of hospitalization was 16-24 days (average 20 days). Follow up for 6-12 months (average eight months) was performed in 15 cases, all wounds were primary healed without infection,dislocation, lower extremity deep vein thrombosis, hip dislocation or subluxation and death. The function of hip joint was satisfied in 12 patients. Conclusion: artificial long-stem femoral head replacement for the treatment of unstable intertrochanteric fractures in the elderly is a reliable, feasible and effective method which can decrease mortality and improve life quality.
