人工股骨头置换治疗高龄转子间骨折与股骨颈骨折:随访比较  

Hemiarthroplasty treats intertrochanteric fractures and femoral neck fractures in the elderly: comparison of follow-up

作　　者：张寿[1] 孔长庚[1] 邢势[1] 金旭红[1] 王和杰[1] 丁晓莉[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院骨科中心,海南省海口市570208

出　　处：《中国组织工程研究》2014年第53期8570-8574,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:人工股骨头置换治疗高龄移位股骨颈骨折已成为首选治疗方案,但是否应用关节置换作为转子间骨折的初次治疗,目前国内学者还有争论。目的:通过比较人工股骨头置换治疗高龄转子间骨折与股骨颈骨折的疗效,评价人工股骨头置换治疗高龄转子间骨折的效果。方法:纳入老年髋部骨折患者90例,年龄≥80岁,转子间骨折组35例,股骨颈骨折组55例。患者均采用骨水泥型人工关节置换。随访1-5年,从置换过程时间、出血量,置换后负重时间、并发症,Harris评分情况进行比较分析。结果与结论:两组平均随访2.8年,在髋关节间隙变化、疼痛、假体柄松动下沉,假体翻修率等方面,两组比较差异无显著性意义(P>0.05);置换过程中出血量、置换后负重时间、Harris评分差异无显著性意义(P>0.05);转子间骨折组比股骨颈骨折组置换时间稍长(P<0.01)。说明人工关节置换治疗高龄不稳定的转子间粉碎性骨折,具有与股骨颈骨折关节置换同样的治疗效果。BACKGROUND： Hemiarthroplasty is the preferred therapeutic regimen for displaced femoral neck fractures in the elderly patients, but whether it can be applied as the primary treatment of intertrochanteric fractures remains controversial. OBJECTIVE： To compare the efficacy of hemiarthroplasty in treatment of intertrochanteric fracture and femoral neck fractures in the elderly patients, and evaluate the application value of hemiarthroplasty in treatment of intertrochanteric fractures in the elderly patients. METHODS： Ninety elderly patients with hip fracture were included in this study, at the age of 〉/ 80 years old. There were 35 cases in intertrochanteric fracture group and 55 cases in femoral neck fracture group. All involved patients were treated with cemented hemiarthroplasty and followed up for 1-5 years. The time of replacement procedure, intraoperetive blood loss, weight-bearing time after replacement, complications, Harris score were compared and analyzed in the two groups. RESULTS AND CONCLUSION： The average follow-up time was 2.8 years in the two groups. There was no significant difference in the hip joint space, pain, and loosening of the prosthesis handle between the two groups （P 〉 0.05）. The prosthesis revision rate, intraoperative blood loss, weight-bearing time after replacement, and Harris score showed no significant difference in the two groups （P 〉 0.05）. The time of replacement procedure in the intertrochanteric fracture group was significantly longer than that in the femoral neck fracture group （P 〈 0.01）. Experimental findings indicate that, hemiarthroplasty has equal effect in treatment of unstable intertrochanteric fractures and femoral neck fractures in the elderly patients.

关 键 词：股骨颈骨折 髋骨折 髋假体 年龄因素 植入物 人工假体 人工股骨头置换 转子间骨折 高龄 

分 类 号：R318[医药卫生—生物医学工程]