J4 ›› 2012, Vol. 11 ›› Issue (12): 47-49.

• 临床医学 • 上一篇    下一篇

加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折例效果评价

  

  1. 大理学院大理教学医院,云南大理 671000
  • 收稿日期:2012-05-29 出版日期:2012-12-15 发布日期:2012-12-15
  • 作者简介:张继源,主任医师,主要从事骨科学研究.

Effect of Artificial Long-stem Femoral Head Replacement for the Treatment of Unstable Intertrochanteric Fractures of 15 Elderly Patients

  1. Dali Teaching Hospital of Dali University, Dali, Yunnan 671000, China
  • Received:2012-05-29 Online:2012-12-15 Published:2012-12-15

摘要:

目的:分析和评价加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折的方法及疗效。方法:本组15例,男10例,女
5例;年龄70~90岁,平均79岁。骨折按Evans分类,IIIA型9例,IIIB型6例。取髋关节后外侧切口,术中注意保留股骨大、小转子部位
的骨折块,用骨水泥固定,争取将其重新复位。由于股骨颈及股骨距骨缺损,在插入人工股骨柄之前可用试模测试。股骨距部位
的骨缺损用骨水泥充填重塑,关节腔内置负压引流管48~72 h。结果:15例患者均康复出院。住院时间16~24 d,平均20 d。均获
得随访,平均随访时间8个月(6~12个月),伤口均一期愈合,无感染,无假体松动,无下肢深静脉栓塞发生,无髋关节脱位或半脱
位发生,无病人死于手术并发症,12例病人髋关节功能满意。结论:加长柄人工股骨头置换术是治疗高龄股骨粗隆部不稳定骨
折的可靠方法,其操作可行,疗效满意,可降低死亡率、改善生活质量。

关键词: 股骨粗隆骨折, 加长柄人工股骨头置换, 老年人

Abstract:

Objective: To explore and evaluate the method of artificial long-stem femoral head replacement for the treatment of
unstable intertrochanteric fractures of 15 elderly patients. Methods: Fifteen cases of elderly aged 70-90 years old (average 79 years
old, 10 male and 5 female) were enrolled in study. Fractures were typed according to Evans classification: 9 cases of type IIIA, 6
cases of type IIIB. Applied the posterolateral hip incision, fractured fragments of large trochanter and minor trochanter should be
preserved during the operations that the fragments could be fixed with bone cement. A model could be used before insertion of
artificial femoral shaft because of the defects of femoral neck and femoral calcar. Bone defects in the femoral calcar were stuffed with
bone cement, suction drainage were maintained for 48-72 hours. Results: All fifteen patients were cured and discharged. The period
of hospitalization was 16-24 days (average 20 days). Follow up for 6-12 months (average eight months) was performed in 15 cases, all
wounds were primary healed without infection,dislocation, lower extremity deep vein thrombosis, hip dislocation or subluxation and
death. The function of hip joint was satisfied in 12 patients. Conclusion: artificial long-stem femoral head replacement for the
treatment of unstable intertrochanteric fractures in the elderly is a reliable, feasible and effective method which can decrease mortality
and improve life quality.

Key words: intertrochanteric fractures, artificial long-stem femoral head replacement, elderly

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