远端固定生物型长柄双极人工股骨头置换术结合粗隆重建治疗32例高龄不稳定骨质疏松股骨粗隆间骨折疗效  

Distal fixed biotype long-stemmed bipolar artificial femoral head replacement combined with rough reconstruction in the treatment of 32 elderly patients with unstable osteoporosis and femoral intercarina fracture

作　　者：鲁俊杰[1] 吕志强[1] 李翔[1] 楚利涛[1] 喻斌 杨通宝[1] 王爱国[1] Lu Junjie;Lyu Zhiqiang;Li Xiang;Chu Litao;Yu Bin;Yang Tongbao;Wang Aiguo(Department of Minimally Invasive Orthopedics,Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院微创骨科,郑州450052

出　　处：《中华实验外科杂志》2024年第8期1855-1860,共6页Chinese Journal of Experimental Surgery

基　　金：河南省科技攻关项目(242102310111)。

摘　　要：目的分析远端固定生物型长柄双极人工股骨头置换术结合粗隆重建治疗高龄不稳定骨质疏松股骨粗隆间骨折的临床疗效。方法回顾性分析郑州市骨科医院2018年1月至2021年12月期间32例行远端固定生物型长柄双极人工股骨头置换术结合粗隆重建治疗高龄的不稳定骨质疏松股骨粗隆间骨折患者临床资料,记录所有患者手术时间、术中出血量、切口长度、开始负重时间、完全负重时间、双下肢长度差、住院时间、并发症发生情况;末次随访按照Harris评分标准进行评估,采用百分率(%)描述末次随访患者髋关节功能优良率。结果32例患者术后随访(17.2±2.3)个月,术后(4.8±1.4)d开始助行器辅助下地行走,完全负重时间为(10.2±1.5)周。32例患者均得到完整随访,所有病例无脱位、假体松动、关节感染或异位骨化,并发症发生率21.9%,末次随访时髋关节功能Harris评分结果:优良29例,较好2例,可1例。优良率90.60%。结论生物型远端固定型长柄双极人工股骨头半髋关节置换术结合粗隆重建治疗高龄骨质疏松股骨粗隆间骨折髋关节功能Harris评分优良率高,并发症少,是一种有效治疗方案。ObjectiveTo analyze the clinical efficacy of distal fixed biotype long-stemmed bipolar artificial femoral head replacement combined with rough reconstruction in the treatment of elderly unstable osteoporotic femoral intertrochanteric fractures.MethodsA retrospective analysis was performed on the clinical data of 32 patients with unstable osteoporotic femoral intertrochanteric fracture who underwent distal fixed biologic long-handled bipolar artificial femoral head replacement combined with rough reconstruction in our hospital from January 2018 to December 2021,and the operation time,intraoperative blood loss,incision length,time to start weight bearing,time to complete weight bearing,length difference between both lower limbs,length of hospital stay,and occurrence of complications were recorded.Postoperatively,they were evaluated according to the Harris scoring criteria.The percentage(%)was used to describe the rate of excellent hip joint function in patients at the last follow-up.ResultsAfter follow-up of(17.2±2.3)months,walkers-assisted walking began on(4.8±1.4)days after operation,and the time of full weight-bearing was(10.2±1.5)weeks.All 32 patients were completely followed up,and all cases had no dislocation,prosthesis loosening,joint infection or heterotopic ossification,and the complication rate was 21.9%,and the Harris score of hip function at the last follow-up was excellent in 29 cases,good in 2 cases,and fine in 1 case with the excellent-good rate of 90.60%.ConclusionBiologic distal fixed long-stemmed bipolar artificial femoral head hemihip arthroplasty combined with rough reconstruction is an effective treatment option for the treatment of elderly osteoporosis intertrochanteric femoral fractures,with a high Harris score and few complications.

关 键 词：人工股骨头 关节置换术 骨质疏松 重建 高龄 

分 类 号：R687.3[医药卫生—骨科学]