高龄骨质疏松陈旧性股骨颈骨折:应根据股骨距-髓腔比率选择股骨假体  

Old femoral neck fractures with senile osteoporosis: choice of femoral prosthesis according to femoral calcar-medullary cavity ratio

作　　者：朱旭日 孙光权[2] 刘锌[1] 陈国庆[1] 杜斌[2] 

机构地区：[1]南京中医药大学,江苏省南京市210029 [2]江苏省中医院骨科,江苏省南京市210029

出　　处：《中国组织工程研究》2015年第17期2631-2636,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:高龄骨质疏松陈旧性股骨颈骨折手术难点多,术中术后并发症较多且远期效果不佳。目的:探索高龄骨质疏松陈旧性股骨颈骨折病患者髋关节置换的临床疗效。方法:收集2012年10月至2014年7月收治高龄骨质疏松陈旧性股骨颈骨折患者20例,采用后外侧入路进行人工髋关节置换治疗,其中14例行全髋关节置换初次置换生物型假体,6例行半髋置换使用柱形翻修直柄生物型假体。结果与结论:置换后获3-24个月随访。高龄骨质疏松陈旧性股骨颈骨折患者髋关节Harris评分与置换前相比明显上升。置换后X射线片显示股骨柄生物充填固定良好,置换后3个月X射线片上均获骨性固定。说明高龄骨质疏松陈旧性股骨颈骨折可采用髋关节置换的外科治疗方法,而根据高龄骨质疏松陈旧性股骨颈骨折患者股骨距-髓腔比率选择股骨假体类型及手术方式,可以使患者更有效地恢复髋关节功能。BACKGROUND： Old femoral neck fractures with senile osteoporosis have more surgical difficulties. There are a lot of intraoperative and postoperative complications and long-term effects are poor. OBJECTIVE： To explore the clinical outcomes of hip arthroplasty in patients with old femoral neck fractures with senile osteoporosis. METHODS： From October 2012 to July 2014, 20 patients with old femoral neck fractures and senile osteoporosis were enrolled in this study. Posterolateral approach was used to perform hip arthroplasty. Of them, 14 patients received primary total hip arthroplasty with biological prosthesis, and 6 patients were subjected to semi-hip arthroplasty with straight shank cylindrical renovated biological prosthesis. RESULTS AND CONCLUSION： The patients were followed up for 3 to 24 months. Harris score was apparently increased after arthroplasty in patients with old femoral neck fractures and senile osteoporosis compared with pre-arthroplasty. Postoperative radiographs revealed that femoral stem biological fixation was good. Bone fixation was visible in radiographs at 3 months after arthroplasty. These findings suggested that old femoral necl~ fractures and senile osteoporosis could be treated with hip arthroplasty. To select the type of prosthesis and surgical methods according to the femoral calcar-medullary cavity ratio in patients with old femoral neck fractures and senile osteoporosis can effectively restore the function of hip joint.

关 键 词：股骨颈骨折 关节成形术 置换 髋 髋假体 骨质疏松 植入物 人工假体 陈旧性股骨颈骨折 关节置换 Dorr分型 假体选择 关节周围挛缩 手术技巧 临床疗效 

分 类 号：R318[医药卫生—生物医学工程]