关节置换治疗高龄不稳定股骨粗隆间骨折  

Hip arthroplasty for unstable intertrochanteric femoral fractures in elderly

作　　者：王骜 代岩 严伟 邹德宝 李磊 余昕 侯燕 王志洲 姜红江 WANG Ao;DAI Yan;YAN Wei;ZOU De-bao;LI Lei;YU Xin;HOU Yan;WANG Zhi-zhou;JIANG Hong-jiang(The First Clinical Medical College,Anhui University of Traditional Chinese Medicine,Hefei 230012,Anhui,China;Shandong Wendeng Orthopaedic Hospital,Weihai 264400,Shandong,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230012 [2]山东省文登整骨医院,山东威海264400

出　　处：《中国矫形外科杂志》2025年第6期566-569,共4页Orthopedic Journal of China

基　　金：国家中医药管理司共建项目(编号:GZY-KJS-SD-2023-029);山东省医药卫生科技项目(编号:202304071340)。

摘　　要：[目的]探讨人工关节置换治疗高龄不稳定股骨粗隆间骨折(intertrochanteric femoral fracture,ITF)的临床效果。[方法]回顾性分析2013年1月1日—2023年12月31日山东省文登整骨医院骨关节三科收治的28例关节置换治疗高龄不稳定ITF患者的临床资料,评价临床及影像结果。[结果]所有患者均顺利完成手术,手术时间平均(59.9±5.4)min,术中失血量平均(269.8±76.4)mL。患者均获6个月以上随访。随着术后1、3、6个月的时间推移,VAS评分[(3.9±0.6),(2.1±0.4),(0.8±0.4),P<0.001]、Harris评分[(73.2±3.5),(79.3±4.6),(83.3±2.2),P<0.001]、髋关节伸屈ROM[(95.6±2.3)°,(113.8±5.4)°,(134.9±3.5)°,P<0.001]、内-外旋ROM[(63.1±7.0)°,(72.1±6.0)°,(78.6±2.5)°,P<0.001]均显著改善。影像方面,与术后即刻相比,末次随访时颈干角、头颈长度、前倾角,假体位置均无显著变化(P>0.05)。[结论]关节置换治疗高龄不稳定ITF能取得良好效果,患者术后可尽早进行康复锻炼,减少患者痛苦。[Objective]To investigate the clinical consequence of hip arhtroplasty in the treatment of unstable intertrochanteric femoral fracture(ITF)in elderly.[Methods]A retrospective study was conducted on 28 elderly patients who received hip arthroplasty for unstable ITF in our hospital from January 1,2013 to December 31,2023.The clinical and imaging documents were evaluated.[Results]All patients had operation performed successfully with operation time of(59.9±5.4)min and intraoperative blood loss of(269.8±76.4)mL,and were followed up for more than 6 months.With time1 month,3 months and 6 months postoperatively,the VAS score[(3.9±0.6),(2.1±0.4),(0.8±0.4),P<0.001],Harris score[(73.2±3.5),(79.3±4.6),(83.3±2.2),P<0.001],hip extensionflexion ROM[(95.6±2.3)°,(113.8±5.4)°,(134.9±3.5)°,P<0.001]and internal-external rotation ROM[(63.1±7.0)°,(72.1±6.0)°,(78.6±2.5)°,P<0.001]were significantly improved.As for imaging,there were no significant changes in shaft-neck angle,head and neck length,anteversion of the femoral component at the last follow-up compared with those immediate postoperatively(P>0.05).[Conclusion]Hip arthroplasty achieve good results in the treatment of unstable ITF in elderly,in which the patients can undergo rehabilitation exercise as soon as possible after surgery to reduce the pain.

关 键 词：高龄 粗隆间骨折 关节置换术 

分 类 号：R683.42[医药卫生—骨科学]