全髋关节置换术联合钢丝张力带治疗老年不稳定股骨转子间骨折  

Clinical Effect of Total Hip Replacement Combined with Steel Wire Tension Band in the Treatment of Unstable Intertrochanteric Fractures of the Elderly

作　　者：程相俊 李健[1] 谢小伟 CHENG Xiangjun;LI Jian;XIE Xiaowei(Department of Orthopaedics,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院骨科,重庆400010

出　　处：《湖北民族大学学报（医学版）》2021年第2期38-40,共3页Journal of Hubei Minzu University(Medical Edition)

基　　金：重庆市医学科研基金项目(20142025)

摘　　要：目的探讨全髋关节置换术联合钢丝张力带治疗老年不稳定股骨转子间骨折的近期临床疗效。方法回顾性分析2016年6月-2019年7月收治的53例老年不稳定型股骨转子间骨折的临床资料,男21例,女32例;年龄75~98岁,平均84.4岁;左侧30例,右侧23例致伤原因:跌倒伤44例,交通伤8例,压扎伤1例。按Evans-Jensen分型:Ⅱ型7例,Ⅲ型23例,Ⅳ型23例。所有病例均采用加长型长柄全髋关节置换术,大转子骨折采用钢丝张力带固定。术后无需外固定,记录临床及影像学结果,根据Harris髋关节评分评价术后功能。结果本组伤口均一期愈合,随访14~49个月,平均23.5个月,大转子骨折均愈合,髋关节功能明显改善。临床结果按Harris评估标准,优36例,良15例,可2例,差0例,优良率96.2%。结论全髋关节置换术联合钢丝张力带治疗老年不稳定性股骨转子间骨折,疗效可靠,并发症少,术后可早期功能锻炼,有利于骨折愈合和患肢功能恢复。Objective To investigate the short-term clinical effect of total hip arthroplasty combined with steel wire tension band in the treatment of elderly patients with unstable intertrochanteric fracture.Methods The clinical data of 53 elderly patients with unstable intertrochanteric fractures from June 2016 to July 2019 were retrospectively analyzed(21 males and 32 females).They were 75~98 years old,with an average of 84.4 years old(30 cases on the left side and 23 cases on the right side).There were 44 cases of fall injuries,8 cases of traffic injuries,and 1 case of compression injuries.According to the Evans-Jensen classification,there were 7 cases of typeⅡ,23 cases of typeⅢ,23 cases of typeⅣ.All cases were treated with lengthened long handle total hip arthroplasty,and the greater trochanter fracture was fixed with steel wire tension band.No external fixation was required after surgery.The clinical and imaging results were recorded,and the postoperative function was evaluated according to the Harris hip score.Results All wounds in this group healed in the first stage.The follow-up period was 14 to 49 months,with an average of 23.5 months.The greater trochanter fractures all healed,and the hip joint function was significantly improved.According to Harris evaluation criteria,36 cases were excellent,15 cases were good,2 cases were fair,and 0 cases were poor.The excellent and good rate was 96.2%.Conclusions Total hip arthroplasty combined with steel wire tension band in the treatment of elderly patients with unstable intertrochanteric fracture has reliable curative effect,less complications,early functional exercise after operation,which is conducive to fracture healing and limb function recovery.

关 键 词：全髋关节置换术 钢丝张力带 股骨转子间骨折 老年 不稳定 

分 类 号：R687.3[医药卫生—骨科学]