前外侧入路人工关节置换治疗股骨转子下骨折并股骨颈陈旧性骨折  

Treatment of fresh subtrochanteric fracture combined with old femoral neck fracture with hemiarthoplasty through anterolateral approach

作　　者：李强[1] 谢祥仁[1] 王全兵[1] 卢娟[2] 

机构地区：[1]十堰市人民医院骨科,湖北十堰442000 [2]湖北医药学院基础医学院,湖北十堰442000

出　　处：《中国骨伤》2015年第11期1056-1059,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：探讨股骨转子下骨折并股骨颈陈旧性骨折经一次性关节置换术的临床疗效。方法 ：自2003年10月至2013年10月,对7例外伤性股骨转子下新鲜骨折伴股骨颈陈旧性骨折患者行一次性人工髋关节置换术,其中男5例,女2例;年龄69-80岁,平均74.5岁。股骨颈骨折按照Garden分型：Ⅳ型2例,Ⅴ型5例。股骨骨折类型按照AO分类均为A1型长斜形股骨转子下骨折,均采用生物涂层长柄股骨假体。术后观察其并发症并采用Charnley评分系统评价髋关节功能。结果：7例患者均获随访,时间12-24个月,平均18个月。术后泌尿系统感染1例,深静脉栓塞1例。5例患者在术后6个月恢复步行能力,2例在1年后仍需扶拐步行。按Charnley髋关节功能评分标准,总分（15.0±2.5）分,其中优4例,良2例,中1例。结论 ：前外侧入路人工髋关节置换治疗股骨转子下骨折并股骨颈陈旧性骨折,具有关节稳定性好、并发症少、恢复快、疼痛轻、可早期下地活动的优点。Objective：To explore the clinical effects of one stage hemiarthroplasty in treating fresh subtrochanteric fracture combined with old femoral neck fracture. Methods：From October 2003 to October 2013,7 patients with fresh subtrochanteric fracture and old femoral neck fracture were treated with hemiarthroplasty in one stage. There were 5 males and 2females,aged from 69 to 80 years old with an average of 74.5 years. According to the Garden classification,2 cases were typeⅣ and 5 cases were type Ⅴ. According to the AO classification of subtrochanteric fracture,all cases were type A1（long oblique femoral subtrochanteric fractures）. Biological coating long handle femoral prosthesis was used in the patients. The hip joint functions were assessed according to Charnley scoring system after all hemiarthroplasty. Results：Seven patients were followed up from 12 to 24 months with an average of 18 months. There were 1 case with urinary system infection and 1 case with deep venous thrombosis. Of all,5 cases recovered the walk ability at 6 months after operation and 2 cases could walk with the help of the crutch at 1 year after operation. According to Charnley scoring system to assess the hip joint function,the total Charnley scores reached 15.0 ±2.5,and 4 cases got an excellent results,2 good,1 fair. Conclusion：Arthroplasty through anterolateral approach can obtain satisfactory clinical effects in treating fresh subtrochanteric fracture combined with old femoral neck fracture,it has advantages of good joint stability,little pain,less complication,quickly recover,early activities on fields.

关 键 词：髋骨折 股骨颈骨折 前外侧入路 关节成形术 置换 髋 

分 类 号：R683.42[医药卫生—骨科学]