CAJ | 학술논문

目的探讨人工半髋置换术治疗高龄髋部骨折患者的特殊要点.方法回顾性分析2008年1月-2010年12月对采用半髋置换治疗的138例高龄髋部骨折患者临床资料.其中男43例,女95例;年龄75～103岁,平均82.8岁.致伤原因:摔伤98例,撞伤32例,扭伤8例.股骨颈骨折84例(GardenⅢ型33例,Ⅳ型51例),股骨转子间骨折54例(Jensen-Evans分型:Ⅱ型3例,Ⅲ型6例,Ⅳ型25例,V型18例,R型2例).术后按Harris评分标准进行随访评价.结果本组术后下床活动时间平均4.5 d(3～12 d).平均随访24.4个月(10～45个月),无假体松动、下沉、感染等.术后由于再次外伤,发生1例假体脱位、2例假体远端股骨干骨折.术后6个月Harris 评分平均86.8分(52～100分),其中优42例,良59例,可19例,差5例,优良率为80.8％.结论在充分做好术前、术中、术后各项措施的前提下,半髋置换治疗高龄患者髋部骨折是一种较好的方法.
목적 탐토인공반관치환술치료고령관부골절환자적특수요점.방법 회고성분석2008년1월-2010년12월대채용반관치환치료적138례고령관부골절환자림상자료.기중남43례,녀95례;년령75～103세,평균82.8세.치상원인:솔상98례,당상32례,뉴상8례.고골경골절84례(GardenⅢ형33례,Ⅳ형51례),고골전자간골절54례(Jensen-Evans분형:Ⅱ형3례,Ⅲ형6례,Ⅳ형25례,V형18례,R형2례).술후안Harris평분표준진행수방평개.결과 본조술후하상활동시간평균4.5 d(3～12 d).평균수방24.4개월(10～45개월),무가체송동、하침、감염등.술후유우재차외상,발생1례가체탈위、2례가체원단고골간골절.술후6개월Harris 평분평균86.8분(52～100분),기중우42례,량59례,가19례,차5례,우량솔위80.8％.결론 재충분주호술전、술중、술후각항조시적전제하,반관치환치료고령환자관부골절시일충교호적방법.
Objective To investigate the key points of treating elder patients with hip fractures by hemiarthroplasty.Methods Clinical data of 138 elder patients with hip fractures undergone hemiarthroplasty between January 2008 and December 2010 were analyzed retrospectively.There were 43 males and 95 females at mean age of 82.8 years(range,75-103 years).Injury causes included fall from height(n=98),contusion(n=32)and sprain(n=8).There were 84 patients with femoral neck fractures(33 patients with Garden type Ⅲ,51 with type Ⅳ)and 54 patients with intertrochanteric fractures(three patients of Jensen-Evans type Ⅱ,six with type Ⅲ,25 with type Ⅳ,18 with type V,two with type R).Follow-up evaluation was performed using Harris scoring system.Results The ambulation period was average 4.5 days(range,3-12 days).Follow-up was average 24.4 months(range,10-45 months),which presented no loosening,subsidence or infection of prostheses.Due to additional trauma postoperatively,one patient suffered from prosthesis dislocation and two from fractures of distal prosthetic femoral shaft.Harris score at six months postoperatively was average 86.8 points(range,52-100 points),with excellent results in 42 patients,good in 59,fair in 19 and poor in five,with excellence rate of 80.8％.Conclusion With full accomplishment of peri-,intra-and post-operative measures,hemiarthroplasty is a suitable choice for treating hip fractures in the elderly patients.