中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2013年
12期
1155-1158
,共4页
股骨颈骨折%关节成形术,置换,髋%内固定器%治疗失败
股骨頸骨摺%關節成形術,置換,髖%內固定器%治療失敗
고골경골절%관절성형술,치환,관%내고정기%치료실패
Femoral neck fractures%Arthroplasty,replacement,hip%Internal fixators%Treatment failure
目的 观察股骨颈骨折内固定失败后行全髋关节置换术(total hip arthroplasty,THA)治疗的早期疗效,探讨其手术技术及假体选择要点. 方法 回顾性分析2007年1月-2012年12月采用THA治疗股骨颈骨折内固定失败后患者36例,其中男21例,女15例;年龄46～72岁,平均58.6岁.内固定失败表现:股骨头坏死13例,骨折不愈合8例,骨折不愈合合并股骨头坏死15例.36例患者均采用生物型固定假体,其中25例患者选择近端固定的假体柄,11例患者选择远端固定的假体柄.采用Harris评分比较患者术前及随访时的患髋功能. 结果 所有患者均获得26 ～ 52个月随访,平均32.5个月.髋关节功能Harris评分由术前平均26.3分提高到术后83.6分,其中优12例,良22例,可2例,优良率94％. 结论 对于股骨颈骨折内固定失败的患者,行挽救性THA能有效改善髋关节功能,提高患者的生活质量.
目的 觀察股骨頸骨摺內固定失敗後行全髖關節置換術(total hip arthroplasty,THA)治療的早期療效,探討其手術技術及假體選擇要點. 方法 迴顧性分析2007年1月-2012年12月採用THA治療股骨頸骨摺內固定失敗後患者36例,其中男21例,女15例;年齡46～72歲,平均58.6歲.內固定失敗錶現:股骨頭壞死13例,骨摺不愈閤8例,骨摺不愈閤閤併股骨頭壞死15例.36例患者均採用生物型固定假體,其中25例患者選擇近耑固定的假體柄,11例患者選擇遠耑固定的假體柄.採用Harris評分比較患者術前及隨訪時的患髖功能. 結果 所有患者均穫得26 ～ 52箇月隨訪,平均32.5箇月.髖關節功能Harris評分由術前平均26.3分提高到術後83.6分,其中優12例,良22例,可2例,優良率94％. 結論 對于股骨頸骨摺內固定失敗的患者,行輓救性THA能有效改善髖關節功能,提高患者的生活質量.
목적 관찰고골경골절내고정실패후행전관관절치환술(total hip arthroplasty,THA)치료적조기료효,탐토기수술기술급가체선택요점. 방법 회고성분석2007년1월-2012년12월채용THA치료고골경골절내고정실패후환자36례,기중남21례,녀15례;년령46～72세,평균58.6세.내고정실패표현:고골두배사13례,골절불유합8례,골절불유합합병고골두배사15례.36례환자균채용생물형고정가체,기중25례환자선택근단고정적가체병,11례환자선택원단고정적가체병.채용Harris평분비교환자술전급수방시적환관공능. 결과 소유환자균획득26 ～ 52개월수방,평균32.5개월.관관절공능Harris평분유술전평균26.3분제고도술후83.6분,기중우12례,량22례,가2례,우량솔94％. 결론 대우고골경골절내고정실패적환자,행만구성THA능유효개선관관절공능,제고환자적생활질량.
Objective To detect the initial results of total hip arthroplasty (THA) after failure of internal fixation of femoral neck fractures and investigate the key points in surgical procedures and prosthesis selection.Methods A retrospective analysis was performed on 36 cases who had THA for femoral neck fractures due to the initially failed internal fixation between January 2007 and December 2012.There were 21 males and 15 females,with age ranging from 46 to 72 years (mean,58.6 years).After internal fixation,13 cases were complicated by femoral head necrosis,eight fracture nonunion,and 15 fracture nonunion combined with femoral head necrosis.All the 36 cases had cementless THA,including proximally fixed stem in 25 cases and distally fixed stem in 11 cases.Harris hip score was assessed before operation and at follow-up.Results All the cases received a follow-up of 26-52 months (mean,32.5 months).Mean Harris hip score improved from 26.3 to 83.6,including excellent results in 12 cases,good in 22,and fair in two,with excellence-good rate of 94％.Conclusion With respect to the failed internal fixation of femoral neck fractures,THA is an effective remedial method to improve hip function and quality of life of the patients.
