生物型长柄人工股骨头治疗老年股骨转子间不稳定型骨折27例临床分析  

Treatment of elderly femoral unstable intertrochanteric fractures with uncemented long stem bipolar prosthetic prosthesis

作　　者：郭珊成[1] 张峡[1] 郝勇[1] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400037

出　　处：《第三军医大学学报》2010年第16期1793-1796,共4页Journal of Third Military Medical University

摘　　要：目的评价应用非骨水泥型长柄双极股骨头置换治疗高龄患者不稳定粗隆间骨折的方法及疗效。方法 2004年7月至2007年9月我院收治27例老年不稳定粗隆间骨折患者,男性12例,女性15例,年龄71～91岁,均为股骨转子间粉碎性骨折,骨折类型按Evans-Jenson分类,ⅡA:9例,ⅡB:11例,Ⅲ:7例。均行加长柄双极股骨头置换。结果本组手术过程顺利,住院期间无人工关节脱位、感染及下肢深静脉血栓形成等并发症。门诊复查随访期间1例死于慢性支气管炎呼吸衰竭。3例出院后未获随访,23例随访时间6～37个月,平均19个月,获得随访的患者中无1例关节脱位,人工假体均无松动、下沉及断裂。最后1次随访时Harris评分平均为84.6分。结论加长柄双极股骨头置换治疗高龄患者股骨粗隆间不稳定骨折创伤小,并发症少,是一种安全、有效的治疗方法。Objective To evaluate the methods and outcomes of uncemented long stem bipolar prosthetic prosthesis for the management of unstable intertrochanteric fractures in the elderly.Methods From July 2004 to September 2007,27 elderly patients with unstable intertrochanteric fractures,12 males and 15 females,with an age ranging from 71 to 91 were treated with uncemented long stem bipolar prosthetic prosthesis.There were 9 cases with type ⅡA of the fracture,11 cases withⅡB,and 7 cases with Ⅲ according to Evans-Jenson classification.Results The operation was performed smoothly in all patients,and no dislocation,infection and deep venous thrombosis of lower limbs occurred.There were 3 patients lost in follow-up and 1 patient died due to sever respiratory failure during the follow-up period.The rest 23 patients were followed up for 6 to 37 months （average 19 months）.No dislocation,infection,loose,sink of the prosthesis was found in all the cases during the followed-up period.Their Harris score reached 84.6.Conclusion Using uncemented long-stem bipolar prosthetic prosthesis replacement for management of unstable intertrochanteric fractures in elderly is a safe and effective method,with small trauma and lesser complications.

关 键 词：髋假体 关节成形术 置换 髋 髋骨折 老年人 

分 类 号：R318.17[医药卫生—生物医学工程] R683.42[医药卫生—基础医学]