中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (17): 3071-3074.doi: 10.3969/j.issn.1673-8225.2011.17.009

• 人工假体 artificial prosthesis • 上一篇    下一篇

含抗生素骨水泥股骨柄与非骨水泥髋臼金属托结合全髋置换治疗中老年股骨颈骨折内固定失败19例

胡孔足1，桂斌捷1，卜海富1，周  健1，张先龙2，沈  灏2   

  1. 1安徽医科大学第一附属医院骨科一病区，安徽省合肥市 230022
    2上海交通大学附属第六人民医院骨科，上海市200233
  • 收稿日期:2010-11-25 修回日期:2011-03-23 出版日期:2011-04-23 发布日期:2011-04-23
  • 通讯作者: 卜海富，教授，主任医师，安徽医科大学第一附属医院骨科一病区，安徽省合肥市230022 gukezazh@yahoo.com.cn
  • 作者简介:胡孔足☆，男，1974年生，安徽省宿松县人，汉族，2010年上海交通大学医学院毕业，博士，主治医师，主要从事关节、创伤研究。 hukongzu@yahoo.com.cn

Treatment of failed internal fixation for adult-aged femoral neck fracture with combined total hip arthroplasty with cementless cup and ontiboiotic cemented femoral stem in 19 cases

Hu Kong-zu1, Gui Bin-jie1, Bu Hai-fu1, Zhou Jian1, Zhang Xian-long2, Shen Hao2   

  1. 1Section I, Department of Orthopedic Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei  230022, Anhui Province, China
    2Department of Orthopedics, Sixth People’s Hospital of Shanghai Jiao Tong University, Shanghai  230022, China
  • Received:2010-11-25 Revised:2011-03-23 Online:2011-04-23 Published:2011-04-23
  • Contact: Bu Hai-fu, Professor, Chief physician, Section I, Department of Orthopedic Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China gukezazh@yahoo.com.cn
  • About author:Hu Kong-zu☆, Doctor, Attending physician, Section I, Department of Orthopedic Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China hukongzu@yahoo.com.cn

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351

被引次数

2

摘要：

背景：中老年股骨颈骨折内固定失败后的治疗充满挑战性，最佳治疗方法尚未达到一致。
目的：观察含抗生素骨水泥股骨柄与非骨水泥髋臼金属托组合的全髋关节置换治疗股骨颈骨折内固定失败的效果。
方法：纳入股骨颈骨折内固定失败后行人工全髋关节置换患者19例，假体均为含抗生素骨水泥股骨柄与非骨水泥髋臼金属托组合的全髋关节。髋臼侧采用生物性假体压配固定，股骨侧采用带抗生素骨水泥假体固定。12例选取金属-聚乙烯承重界面，7例选取陶瓷-聚乙烯承重界面。置换后随访，定期摄片监测假体位置，并指导功能锻炼，记录髋关节功能恢复状况。
结果与结论：手术时间(110±55) min，术中出血量(510±60) mL，置换后出血量(310±40) mL。切口均一期愈合，未见局部红肿，脓性渗出。双下肢畸形恢复，长度相差均小于1 cm。19例全部获得随访，随访期间所有病例均未见假体松动征象。置换后1年随访Harris髋关节评分显著高于置换前(P < 0.05)，其中优10例，良8例，中1例，差0例，优良率为94.7%。提示全髋关节置换治疗股骨颈骨折内固定失败有一定困难，采用含抗生素骨水泥股骨柄与非骨水泥髋臼金属托组合，可加强围手术期处理以及针对性的功能锻炼，患者关节疼痛以及活动度可得到明显改善。

关键词: 内固定失败, 全髋关节置换, 股骨颈骨折, 骨水泥, 髋关节功能

Abstract:

BACKGROUND: Surgical treatment of failed internal fixation for adult-aged femoral neck fracture is challenging. The optimal procedure has not been defined. 
OBJECTIVE: To study the effect of total hip arthroplasty with cementless cup and antibiotic cemented femoral stem in the treatment of failed internal fixation for adult-aged femoral neck fracture.
METHODS: Nineteen cases with failed internal fixation for adult-aged femoral neck fracture were performed total hip arthroplasty with cementless cup and antibiotic cemented femoral stem. The surgical characteristics and results were recorded.
RESULTS AND CONCLUSION: The operation time was (110±55) minutes, intra-operative blood loss was (510±60) mL, and post-operative blood loss was (310±40) mL. All the 19 cases were followed up. No implant loosening signs were found in X-ray films. The hip function was evaluated with Harris scores system, and the scores were improved postoperatively (P < 0.05). The results were graded as excellent in 10, good in 8, fair in 1 and poor in 0, and the excellent and good rate was 94.7%. Despite the technical challenges, total hip arthroplasty with cementless cup and antibiotic cemented femoral stem is effective to treat failed internal fixation for adult-aged femoral neck fracture.

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