中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9774-9777.doi: 10.3969/j.issn.1673-8225.2011.52.020

• 人工假体 artificial prosthesis • 上一篇    下一篇

人工股骨头置换治疗高龄股骨转子间骨折与股骨颈骨折的比较

左进步，余  磊，梁宏伟，王  伟，赵  斌，齐进如   

  1. 武装警察部队北京总队医院骨科，北京市  100027
  • 收稿日期:2011-07-01 修回日期:2011-11-01 出版日期:2011-12-24 发布日期:2011-12-24
  • 作者简介:左进步★，男，1970年生，山东省淄博市人，2008年首都医科大学毕业，硕士，副主任医师，主要从事创伤骨科及脊柱外科研究。 zjbjinbu@sina.com

Artificial femoral head replacement for intertrochanteric fractures versus femoral neck fractures in elderly patients

Zuo Jin-bu, Yu Lei, Liang Hong-wei, Wang Wei, Zhao Bin, Qi Jin-ru   

  1. Department of Orthopedics, Beijing  Municipal Corps  Hospital of Chinese People’s Armed Police Forces, Beijing  100027, China
  • Received:2011-07-01 Revised:2011-11-01 Online:2011-12-24 Published:2011-12-24
  • About author:Zuo Jin-bu★, Master, Associate chief physician, Department of Orthopedics, Beijing Municipal Corps Hospital of Chinese People’s Armed Police Forces, Beijing 100027, China zjbjinbu@sina.com

PDF

479

被引次数

26

摘要：

背景：对于移位明显的股骨颈骨折采用股骨头置换已成为共识，而对于股骨转子间骨折采用人工股骨头置换仍存在分  歧。
目的：通过比较人工股骨头置换治疗高龄股骨转子间骨折与股骨颈骨折的疗效及预后，评价双极骨水泥型人工股骨头置换治疗高龄股骨转子间骨折的效果。
方法：2005-06/2009-06采用人工股骨头置换治疗高龄股骨转子间骨折和股骨颈骨折患者共112例，其中股骨转子间骨折组52例，股骨颈骨折组60例。对两组患者的手术时间、出血量、下地负重时间和髋关节功能进行比较分析。
结果与结论：置换后随访12~39个月。按Harris评分评估髋关节功能，股骨转子间骨折组优22例，良25例，可3例，差1例，优良率为92.1%；股骨颈骨折组优28例，良25例，可4例，差1例，优良率为91.3%。股骨颈骨折组的手术时间显著短于股骨转子间骨折组(P < 0.05)，出血量显著低于股骨转子间骨折组(P < 0.05)。但下地负重时间和疗效优良率两组差异无显著性意义。提示人工股骨头置换可作为治疗高龄股骨转子间不稳定骨折的主要方法。

关键词: 高龄, 人工股骨头置换, 股骨转子间骨折, 股骨颈骨折, 植入体

Abstract:

BACKGROUND: Using femoral head replacement for femoral neck fractures which shift significantly has become a consensus, but using artificial femoral head replacement for intertrochanteric fractures is controversial.
OBJECTIVE: To compare the effects and prognosis of artificial femoral head replacement for unstable intertrochanteric fractures and femoral neck fractures in elderly patients, and to evaluate the curative of unstable intertrochanteric fractures in elderly patients with the artificiall femoral head replacement.
METHODS: Totally 112 cases with artificial femoral head replacement for treating unstable intertrochanteric fractures and femoral neck fractures in elderly patients from June 2005 to June 2009 were selected. There were 52 cases in intertrochanteric fractures group, and 60 cases in femoral neck fractures group. Operation time, blood loss, time of post-surgery exercise, and hip function were compared.
RESULTS AND CONCLUSION: All the patients were followed-up for 12 to 39 months after replacement. Hip function was evaluated by Harris score which showed that the excellent and good rate was 92.1%, evaluation excellent for 22 cases, good for 25 cases, fair for 3 cases, and poor for 1 case in the intertrochanteric fractures group, but in the femoral neck fractures group, the excellent and good rate was 91.3%, evaluation excellent for 28 cases, good for 25 cases, fair for 4 cases, and poor for 1 case. Operation time (P < 0. 05) and blood loss (P < 0. 05) in the femoral neck fractures group were significantly lower than those in the intertrochanteric fractures group. There was no significant difference of the time of post-surgery exercise and excellent and good rate of efficacy in the two groups. It is indicated that artificial femoral head replacement can be used as the main method for the treatment of unstable intertrochanteric fractures in the elderly.

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