全髋关节置换术后股骨假体周围骨折的短期疗效随访  

Short-term effect of total hip arthroplasty in patients with periprosthetic femur fracture

作　　者：徐小会[1] 王桂新[1] 贺文建[2] 张振清[1] 段永宏[3] 

机构地区：[1]德州市人民医院骨科,253100 [2]德州市人民医院产科,253100 [3]第四军医大学西京医院急诊外科,西安710032

出　　处：《中华关节外科杂志（电子版）》2015年第5期594-599,共6页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的观察全髋关节置换术(THA)后股骨假体周围骨折手术治疗的短期疗效。方法对德州市人民医院骨科自2011年9月至2014年8月期间因THA术后假体周围骨折治疗的16例(16髋)患者进行了临床随访研究,术中依据温哥华(Vancouver)分型采取不同治疗方案,对治疗后患者髋部疼痛、髋关节功能、生活质量、骨折愈合情况及并发症进行评估。结果 16例患者均获得6~36个月的随访,平均随访时间为(12±7)个月。患者视觉疼痛(VAS)评分由术前(7.1±1.2)分降低到(1.7±1.2)分;Harris评分由术前(36±3)分提高到(82±5)分,评分优良率约为69%。生活质量评价量表SF-12(SF-12)评分中身体健康(PCS)评分由术前(29±4)分,提高到术后(50±5)分;精神健康评分(MCS)由术前(40±6)分,提高到术后(50±4)分,手术前后的差异均具有统计学意义(P<0.01)。结论THA后假体周围骨折,依据Vancouver分型,结合患者具体情况选择合适治疗方法可取得良好的临床疗效及提高患者的生活质量。Objective To observe the short term effect of total hip arthroplasty(THA)inpatients with periprosthetic fracture of femur.Methods A retrospective analysis was performed in 16 patients (16 hips) , who underwent THA with periprosthetic fracture of femur, from Sep.2011 to Aug.2014 in&nbsp;orthopedic department of Dezhou People's Hospital.The clinical results were evaluated by visual analog scale ( VAS) system and Harris hip function scoring system.The patients’ health status was evaluated by using the short form 12-item survey (SF-12).Results The average follow-up duration in this study was (12 ±7) months (range, 6-36 months).All the functions of hip joint improved.The VAS score reduced from preoperative (7.1 ±1.2) to postoperative (1.7 ±1.2), with significant difference (P<0.01).The mean value of the Harris scores was averagely improved from ( 36 ±3 ) preoperatively to ( 82 ±5 ) at the follow-up examination (P<0.01);the excellent or good results rate was 69%.No loosening was observed according to the hip society total hip arthroplasty roentgen graphic evaluation and scoring system.The average physical health score ( PCS ) of SF-12 showed an average improvement from ( 29 ±4 ) preoperatively to (50 ±5) at follow-up (P<0.01).The mental health score (MCS) showed an average improvement from (40 ±6) preoperatively to (50 ±4) at the follow-up (P<0.01).Conclusion Using Vancouver classification and assement of the general condition of the patients can help surgeons to choose appropriate treatment for the patients with periprosthetic fracture after THA, which will lead to good results and improve the patients’ quality of life.

关 键 词：关节成形术 置换 髋 疼痛 假体周围骨折 股骨 疗效 

分 类 号：R687.4[医药卫生—骨科学]