骨水泥固定的双极人工股骨头置换治疗高龄股骨颈骨折的中期随访  

Midterm results of bipolar artificial femoral head arthroplasty in treatment of elder femoral neck fracture

作　　者：杨立新[1] 桑双进 林剑浩[3] 王宏伟[1] 王云程[1] 吴超[1] 

机构地区：[1]北京大兴区红星医院骨外科,北京100076 [2]北京大兴区旧宫医院骨科,北京100076 [3]北京大学人民医院关节中心,北京100044

出　　处：《中国矫形外科杂志》2009年第18期1368-1370,共3页Orthopedic Journal of China

摘　　要：[目的]讨论应用骨水泥固定的双极人工股骨头置换治疗高龄股骨颈骨折的临床疗效。[方法]自1995年9月-2005年2月,对73例高龄股骨颈骨折患者行骨水泥固定的国产双极人工股骨头置换,得到随访的病例49例,其中已死亡2例,余47例平均随访5年5个月,根据Harris评分法和X线资料评定其疗效。[结果]术中大转子后部骨折1例,无血管神经损伤,无切口感染和关节脱位,无围手术期死亡。术后X线假体稍内翻2例,术后合并肺部感染3例,泌尿系感染2例,脑梗塞1例,中枢神经系统功能障碍1例,合并下肢深静脉血栓形成1例。在有最终X线资料的36例中,出现假体下沉2例,骨水泥周围<2mm的透亮带2例,髋关节间隙变窄21例,人工股骨头内凸1例。根据Harris评分法评定,优12例,良26例,中7例,差2例,优良率80.9%。[结论]应用骨水泥固定的双极股骨头置换治疗高龄股骨颈骨折疗效满意,术者应掌握好适应证,做好围手术期管理。[ Objective] To discuss the midterm effects of bipolar artificial femoral head arthroplasty in treatment of elder femoral neck fracture. [ Method] From September 1995 to Febuary 2005,73 elderly patients with femoral neck fracture were operated with domestic bipolar artificial femoral head arthroplasty （average 74 years old）. Forty-seven cases had been followed up for average 65 months. Harris score system and X-ray had been used for evaluation. [ Result ] There was no vessel and nerve injury, no in- fection and dislocation, no perioperative death. The complications included one greater trochanteric fracture ,3 cases with pneumo- nitis ,2 urinary infection, 1 cerebral infarction, 1 dysfunction in central nerve system and 1 case with deep venous thrombosis. Of all the 36 X-rays there were 3 cases with prosthesis subsidence,lucent line lesser 2ram in 2 cases, narrow joint space in 21 cases, protrusion in 1 case. According to the Harris scoring system, there were excellent in 12, good in 26, fair in 7, poor in 2. [ Conclusion ] Bipolar artificial femoral head arthroplasty are reasonable choice for treatment of femoral neck fracture in the elderly. Proper indication and perioperative management is critical to get good resuhs.

关 键 词：股骨颈骨折 股骨头置换 人工股骨头 高龄 

分 类 号：R687.3[医药卫生—骨科学]