骨水泥型人工关节假体置换治疗老年股骨转子间骨折43例  

Cemented total hip replacement for 43 elderly patients with intertrochanteric fractures

作　　者：沈海琦[1] 刘燚[1] 唐金山[1] 桂鉴超[1] 宋华荣[1] 王黎明[1] 

机构地区：[1]南京医科大学附属南京第一医院骨科,江苏省南京市210006

出　　处：《中国组织工程研究与临床康复》2009年第9期1773-1776,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察全髋关节置换治疗老年股骨转子间骨折的效果。方法:回顾性分析2000-03/2005-12南京医科大学附属南京第一医院骨科收治的老年股骨转子间骨折患者43例,男17例,女26例;陈旧性骨折8例,其余35例患者均为新鲜骨折。新鲜骨折类型按Evance分类,Ⅲ型18例,Ⅳ型12例,Ⅴ型5例。全部患者均采用骨水泥型人工关节假体进行置换。记录置换时间,置换过程中出血量,置换后住院天数,Charnley评分及围置换期并发症。结果:43例患者置换均顺利完成,置换时间60～90min,置换过程中出血量200～500mL,平均卧床9.4d。除1例全髋关节置换后由于肺癌死亡外,其余病例均获随访,随访时间6个月～4年。全部患者未出现感染、下肢深静脉血栓、早期脱位等严重并发症,无假体松动、下沉、脱位。置换后9～12个月Charnley评分优23例,良17例,中3例,优良率达到92.8%。结论:全髋关节置换治疗老年股骨转子间骨折能有效恢复关节功能,缓解髋关节疼痛,但要严格掌握适应证,做好置换前综合评估和准备。AIM： To observe the curative effect of total hip replacement on senile intertrochanteric fracture. METHODS： A total of 43 patients with intertrochanteric fracture were selected from Department of Orthopedics, First Hospital of Nanjing Medical University between March 2000 and December 2005, including 17 male and 26 female, 8 cases of old fracture and 35 fresh fracture. According to Evance classification for fresh fracture, 18 cases were type Ⅲ, 12 type Ⅳ and 5 type Ⅴ. All patients underwent cemented total hip replacement. The replacement time, bleeding, hospital days after replacement, Charnley score and peri-operative complications were recorded. RESULTS： Forty-three patients passed the replacement successfully with operation time 60- 90 minutes, bleeding volume 200-500 mL, and average bed stay 9.4 days after operation. Except one died of lung cancer following replacement, and all cases were followed up for 0.5-4 years. No serious complications were found, such as infection, thrombus of deep veins of lower extremity or early dislocation, no prosthesis loosening, subsidence or dislocation. Charnley scores at postoperative months 9-12 were 23 cases of excellent, 17 of good, and 3 of fine, with the excellent and good rate of 92.8%. CONCLUSION： Total hip replacement for senile intertrochanteric fracture can effectively restore joint function and remit the pain of hip joint. Indication and precise preoperative assessment and preparation are very necessary.

关 键 词：关节置换 股骨转子间骨折 老年患者 

分 类 号：R318[医药卫生—生物医学工程]