高龄骨质疏松性股骨粗隆间骨折人工关节置换时大粗隆骨块两种固定方法的比较  

A comparison of two methods of greater trochanteric reattachment in hip arthroplasty for elderly osteoporotic femoral intertrochanteric fractures

作　　者：孟祥德[1] 戴兵[1] 骆洪涛[1] 张浩[1] 司庆华[1] 崔世光[1] 

机构地区：[1]空军航空医学研究所附属医院骨科,北京100089

出　　处：《中国骨质疏松杂志》2010年第6期435-438,434,共5页Chinese Journal of Osteoporosis

摘　　要：目的通过比较分析人工关节置换加SuperCableTM Iso-ElasticTM环扎系统辅助与人工关节置换加克氏针钢丝环扎辅助治疗高龄不稳定型粗隆间骨折的疗效及预后,前瞻性评价人工关节置换两种辅助手段的效果。方法 2001年6月至2009年6月间我科收治高龄股骨粗隆间骨折例患者,男46例,女34例,年龄76～93岁,平均82.3岁。其中人工关节置换加SuperCableTM Iso-ElasticTM环扎系统45例,人工关节置换加克氏针钢丝环扎35例。骨折类型按Evans分型,Ⅰ型26例,Ⅱ型42例,Ⅲ型12例。结果所有患者均得到近期随访,平均随访时间1.5年。SuperCableTM Iso-ElasticTM Cable组住院时间、手术时间、大粗隆骨块固定操作时间短,术中出血量、术后引流量少,术后负重时间早,术后并发症少,术后1个月髋关节功能恢复好,与钢丝固定组比较,均有显著差异(P<0.05)。结论人工关节置换加SuperCableTM Iso-ElasticTM环扎系统辅助治疗高龄粗隆间骨折临床效果令人满意,好于钢丝固定。Objective To compare treatment effect of two trochanterie reattachment methods in hip arthroplasty for elderly femoral intertrochanteric fractures. One group is treated with Iso-Elastic cable reattachment,the other group is treated with stainless steel wires. Methods From June 2001 to June 2009, 80 cases of elderly intertrochanteric fractures were treated by hip arthroplasty. The average age of the patients is 82.3 years（ range,76-93 years）. Among these patients, lso-Elastic cable reattaehment of trochanter were used in 45 patients and stainless steel wires reattachment of troehanter were used in 35 patients. 26 eases were Evans I type, 42 cases were Evans II type and 12 cases were Evans m type. Results All the patients were followed up, the average follow up time was 1.5 years. SuperCableTM Iso-ElasticTM Cable group is better than stainless steel wires group in length of stay, operation duration,greater troehanter reattachment time,blood loss during operation, drainage volume of blood, weightbear time after operation, complication after operation and the Harris hip score. There is significantly difference between the two groups（ P 〈 0.05 ）. Conclusions The effect of SuperCable^TM lso-Elastic^TM Cable greater trochanteric reattachment in hip after operation for elderly femoral intertrochanteric fractures is satisfying. Its effect is better than stainless steel wires reattachment.

关 键 词：股骨粗隆问骨折 人工关节置换 SuperCable^TM Iso.Elastic^TM环扎线缆 老年骨质疏松病人 钢丝 

分 类 号：R683.2[医药卫生—骨科学]