假体置换治疗老年股骨颈头下型骨折的疗效比较  

Prosthetic replacement in treatment of subcapital femoral neck fractures in the old

作　　者：徐莘香[1] 刘一[1] 刘建国[1] 李印良[1] 

机构地区：[1]吉林大学白求恩医学院第一临床学院骨科,长春130021

出　　处：《中华创伤杂志》2001年第9期546-548,共3页Chinese Journal of Trauma

摘　　要：目的　比较双极人工股骨头置换和双极全髋关节置换治疗老年股骨颈头下型骨折的效果。　方法　从 1987年 5月至 1998年 7月 ,5 0例老年股骨颈头下型骨折采用假体治疗 ,平均年龄 73.2岁。其中 18例采用Bateman双极人工股骨头置换 ,32例采用Bateman双极全髋关节置换。全部假体为国产 ,均以骨水泥固定。　结果　两组病例的手术时间和输血量比较 ,差异无显著性意义。 44例平均随访时间为 5年 9个月 ,无一例切口感染 ,无一例死亡与手术有关。在人工股骨头置换组 ,其股骨头脱位、髋部和大腿痛、臼底凸出等并发症的发生率明显高于全髋置换组。　结论　人工股骨头难以与骨性髋臼匹配 ,仅适于身体虚弱的高龄患者。而双极全髋置换以骨水泥固定适于多数老年患者 ,人工股骨头与人工髋臼可以完全匹配 ,关节更稳定 ,可以早期负重 ,并发症少。Objective To compare the results of bipolar femoral hea d replacement (FHR) and bipolar total hip replacement (THR) in the treatment of su bcapital femoral neck fractures (SFNF). Methods Between May 19 87 and July 1998, 50 old patients with SFNF were treated with prosthetic replace ment. The average age was 73.2 years ( 65-90 years ). Of all, 18 cases were tre ated with Bateman bipolar FHR ( Group FHR), and 32 cases treated with Bateman b ipolar THR ( Group THR ). All prostheses were domestic products and were install ed with cement. Results There was no significant difference b etween 2 groups in operation time and blood transfusion. Forty-four patients we re followed up for an average of 5 years and 9 months. No wound infection was fo und and no death related to surgical operation. Complications including hip disl ocation in 2 cases, thigh pain and floor protrusion in Group FHR were significan tly higher than that in Group THR. Conclusions Since FHR is difficult to fit the bony acetabulum, it is only fit for senile cases under poor conditions. However, the bipolar THR installed with cement can be used for most old patients. The femoral head and the acetabulum can match with each other com pletely; such match is more stable and helpful for an earlier bearing with less complications.

关 键 词：股骨颈骨折 髋假体 双极全髋置换 治疗 疗效 

分 类 号：R683.42[医药卫生—骨科学]