中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (48): 8977-8980.doi: 10.3969/j.issn.1673-8225.2011.48.012

• 人工假体 artificial prosthesis • 上一篇    下一篇

全髋关节置换治疗高龄不稳定性股骨转子间骨折：同一机构53例随访

彭  昊，马  进   

  1. 武汉大学人民医院骨科，湖北省武汉市  437300
  • 收稿日期:2011-04-22 修回日期:2011-06-30 出版日期:2011-11-26 发布日期:2011-11-26
  • 通讯作者: 马进，硕士，武汉大学人民医院骨科，湖北省武汉市437300 the_doors@qq.com
  • 作者简介:彭昊☆，男，1963年生，博士，主任医师，教授，博士生导师，主要从事骨科相关研究。penghao5868@163.com

Treatment of unstable femoral intertrochanteric fractures in elderly patients with total hip replacement: A follow-up of 53 cases in the same institution

Peng Hao, Ma Jin   

  1. Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan  437300, Hubei Province, China
  • Received:2011-04-22 Revised:2011-06-30 Online:2011-11-26 Published:2011-11-26
  • Contact: Ma Jin, Master, Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan 437300, Hubei Province, China the_doors@qq.com
  • About author:Peng Hao☆, Doctor, Chief physician, Professor, Doctoral supervisor, Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan 437300, Hubei Province, China penghao5868@163.com

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摘要：

背景：股骨转子间骨折高龄患者选用内固定治疗成功率不高。
目的：观察全髋关节置换治疗高龄不稳定性股骨转子间骨折的效果。
方法：纳入69例年龄大于70岁的不稳定性股骨转子间骨折患者，选用全髋关节置换作为主要治疗手段。记录置换后并发症、死亡周期、髋关节功能Harris评分及恢复正常功能的时间周期。
结果与结论：16例患者失访，剩余53例。7例以上患者死于置换后1年内。置换后第1个月的Harris评分为66±7，第3个月为72±6，第1年为74±5，第3年为76±6，其中27例5年后的Harris评分为76±8。患者恢复下地行走能力的平均时间为28 d。所有患者未出现假体松动和植入感染现象。提示全髋关节置换可作为治疗高龄不稳定性股骨转子间骨折患者的一种有效选择，患者在极低的器械故障风险下能更快地恢复，避免了内固定治疗失败的风险问题，使患者能够在治疗后保持良好的运动功能。

关键词: 全髋关节置换, 半髋关节置换, 动力髋螺钉, 股骨转子间骨折, 不稳定性

Abstract:

BACKGROUND: The success rate of internal fixation for treatment of unstable femoral intertrochanteric fractures in elderly patients is not high.
OBJECTIVE: To observe the treatment effect of total hip replacement on unstable interochanteric fractures in elderly patients.
METHODS: Sixty-nine patients over 70 years old with unstable femoral intertrochanteric fracture were involved. Total hip replacement was performed as the primary treatment in all patients. The postoperative complications, mortality rate, Harris hip score, time to return to normal activities of the patients were taken after replacement. 
RESULTS AND CONCLUSION: Sixteen patients were out of follow-up. Over seven patients died one year after replacement. The Harris hip score was (66±7) at 1 month, (72±6) at 3 months, (74±5) at 1 year, and (76±6) at 3 years. The Harris hip score of 27 patients was (76±8) at 5 years after replacement. Average time to return to normal daily activities of the patients was 28 days. No loosening or infection of the implants was observed. Total hip replacement is a valid treatment option for unstable femoral intertrochanteric fractures in elderly patients. This procedure can offer quick recovery through the reduction of mechanical risk, avoid the risk associated with internal fixation, and enable the patients a good level of functions immediately after surgery.

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