人工股骨头置换治疗高龄股骨转子间不稳定型骨折  

Double-action femoral head replacement for the treatment of unstable femoral intertrochanteric frautures in the elderly

作　　者：张敬东[1] 项良碧[1] 祖启明[1] 刘贵堂[1] 毕研[1] 

机构地区：[1]解放军沈阳军区总医院骨科,辽宁省沈阳市110016

出　　处：《中国组织工程研究》2012年第35期6514-6518,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前对于高龄不稳定型股骨转子间骨折,多应用闭合复位股骨近端髓内钉/防旋股骨近端髓内钉内固定治疗,效果不令人满意。目的:应用双动人工股骨头置换治疗高龄股骨转子间不稳定型骨折的临床效果。方法:采用双动人工股骨头置换治疗高龄不稳定型股骨转子间骨折39例,随访均超过6个月。以Harris评分评估髋关节功能并观察置换后并发症的发生情况。结果与结论:随访6个月Harris评分,优17例,良14例,可8例。并发心功能不全3例,并发肺部感染1例,脱位2例(交流障碍,不能配合置换后康复训练),深静脉血栓2例,泌尿系感染5例,经对症治疗后痊愈。未出现心脏衰竭、应激性溃疡、肺栓塞、假体周围感染、死亡等严重并发症。表明对于严重骨质疏松且合并多系统疾病的高龄股骨转子间不稳定型骨折患者,采用双动人工股骨头置换治疗,可以早期下地负重、减少置换后并发症。BACKGROUND： Femoral intertrochanteric fracture is common fracture in the elderly patients, it was treated with closed and reduction proximal femoral nail/proximal femoral nail anti-rotation internal fixation now, but the treatment effect of the method is not satisfied. OBJECTIVE： To explore the effect of double-action femoral head replacement for the treatment of unstable femoral intertrochanteric fractures in elderly patients. METHODS： Thirty-nine patients with unstable femoral intertrochanteric fractures were cured by double-action femoral head replacement, all the patients were followed-up for more than 6 months. Harris score was used to evaluate the hip joint function, and the complications after replacement were observed. RESULTS AND CONCLUSION： Harris Scores after followed-up for 6 months showed that 17 cases were rated as excellent, 14 cases as good, 8 cases as fair. Three cases of cardiac insufficiency, one case of lung infection, two cases of dislocation （communication barriers, and could not cope with the rehabilitation training after replacement）, two cases of deep vein thrombosis and five cases of urinary tract infection. All the patients were cured after symptomatic treatment. There were no serious complications, such as cardiac failure, stress ulcer, pulmonary embolism, periprosthetic infection or death. The treatment of unstable femoral intertrochanteric fractures with double-action femoral head replacement in elderly patients has the advantages of early ambulation weight and fewer complications after replacement.

关 键 词：骨折 股骨转子间 人工股骨头置换 高龄 骨质疏松 

分 类 号：R318[医药卫生—生物医学工程]