骨水泥型人工股骨头置换术治疗老年不稳定型股骨转子间骨折的研究进展  

Research progress on treatment of unstable intertrochanteric fractures in elderly patients with bone cement type femoral head replacement

作　　者：张士雄 马剑雄[1,2,3] 卢斌 马信龙 ZHANG Shixiong;MA Jianxiong;LU Bin;MA Xinlong(Tianjin University Tianjin Hospital(Tianjin Hospital),Tianjin,300211,P.R.China;Tianjin Institute of Orthopedics,Tianjin,300050,P.R.China;Tianjin Key Laboratory of Orthopedic Biomechanics and Medical Engineering,Tianjin,300050,P.R.China)

机构地区：[1]天津大学天津医院(天津市天津医院),天津300211 [2]天津市骨科研究所,天津300050 [3]天津市骨科生物力学与医学工程重点实验室,天津300050

出　　处：《中国修复重建外科杂志》2024年第9期1143-1148,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家重点研发计划资助项目(2022YFC3601904)。

摘　　要：目的对骨水泥型人工股骨头置换术治疗老年不稳定型股骨转子间骨折的研究进展进行综述。方法查阅国内外有关骨水泥型人工股骨头置换术治疗老年不稳定型股骨转子间骨折的相关文献,从假体类型的选择、股骨近端重建方式以及术后并发症、康复等方面进行总结。结果骨水泥型人工股骨头置换术在老年不稳定型股骨转子间骨折治疗中显示出了良好疗效。置换手术后可获得即刻稳定性,使患者能够迅速负重和恢复行走功能,减少了术后并发症和死亡的发生。然而,由于老年患者普遍存在身体状况差和手术耐受能力较低的问题,术后并发症发生风险显著增加,对术后恢复有显著影响。常见并发症包括深静脉血栓形成、骨水泥植入综合征、关节脱位、假体松动及假体周围骨折等。因此,尽管置换术后早期疗效较好,也需重视术后并发症的预防和管理,以改善老年患者的远期预后。结论对于老年不稳定型股骨转子间骨折,选择骨水泥型人工股骨头置换术时,需严格把握手术指征,通过精细化术前评估、术中操作及有效术后管理,减少并发症的发生,提高患者生活质量。Objective To summarize the latest research progress of bone cement type femoral head replacement in the treatment of unstable intertrochanteric fractures in elderly patients.Methods The literature on the application of bone cement type femoral head replacement for unstable intertrochanteric fractures in elderly patients both domestically and internationally was reviewed,and the findings in aspects of selection of prosthesis types,proximal femoral reconstruction methods,postoperative complications,and rehabilitation were summarized and analyzed.Results The bone cement type femoral head replacement has shown significant effectiveness in the treatment of unstable intertrochanteric fractures in elderly patients.The surgery provides immediate stability,allowing patients to quickly bear weight and regain walking function,thereby reducing the incidences of postoperative complications and mortality.However,due to the generally poor physical condition and low surgical tolerance of elderly patients,the risk of postoperative complications significantly increases,which has a significant impact on patients’postoperative recovery.Common complications include deep vein thrombosis,bone cement implantation syndrome,joint dislocation,prosthesis loosening,and periprosthetic fractures.Therefore,despite the apparent short-term effectiveness of the surgery,it is crucial to emphasize the prevention and management of postoperative complications to improve the long-term prognosis of elderly patients.Conclusion For unstable intertrochanteric fractures in elderly patients,when choosing bone cement type femoral head replacement,it is necessary to strictly adhere to surgical indications,reduce the occurrence of complications,and improve the patients’quality of life through refined preoperative evaluation,intraoperative operation,and effective postoperative management.

关 键 词：股骨转子间骨折 不稳定型骨折 骨水泥型假体 人工股骨头置换术 老年 

分 类 号：R687.3[医药卫生—骨科学]