长柄双动人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折临床分析.docVIP

长柄双动人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折临床分析 　　[摘要] 目的：观察长柄双动人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折的临床疗效。方法：选择2007年1月～2010年10月31例合并骨质疏松的高龄不稳定股骨粗隆间骨折采用长柄双动人工股骨头置换术治疗后患者进行随访。观察手术时间、出血量、Harris关节功能评分、并发症。结果：随访10～30个月，平均19.5个月，所有患者术后5～7 d（平均6 d）下地负重行走。平均手术时间为65 min、出血量平均为450 ml、Harris关节功能评分为88分，未发生重大并发症。结论：人工股骨头置换术对高龄合并骨质疏松的不稳定性股骨粗隆间骨折患者具有缩短手术时间、减少出血量、维持髋关节功能，减少并发症等优点，值得临床推广应用。 　　[关键词] 人工髋关节置换；股骨粗隆间骨折；老年患者；临床分析 　　[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2012）01（a）-024-02 　　 　　Clinical analysis of long stem bipolar arthroplasty for elderly patients with unstable intertrochanteric fractures 　　XU Qin, GAO Jiazhi 　　Department of Emergency Orthopaedics, the People′s Hospital of Weifang City in Shandong Province, Weifang 261041, China 　　[Abstract] Objective: To evaluate the clinical results of long stem bipolar arthroplasty for elderly patients with unstable intertrochanteric fractures. Methods: Chose from January 2007 to October 2010, 31 cases of merger of osteoporosis instability-intertrochanteric fracture used long handle double acting prosthesis replacement after treatment, the follow-up. Observe the time, blood loss, Harris joint function scores, complication. Results: Followed up 10 to 30 months, an average of 19.5 months, all patients who underwent the 5-7 days (average 6 days) walk the earth weight. Average operation time was 65 min, the bleeding on average was 450 ml, Harris joint function score was 88 points, not serious complications. Conclusion: Long stem bipolar femur prosthetic replacement can gain good hip function and decrease the complications of fracture in treating elderly patients with unstable intertrochanteric fractures. The way is worth clinical extending. 　　[Key words] Bipolar arthroplasty; Intertrochanteric fracture; Elderly patients; Clinical analysis 　　 　　股骨粗隆间骨折是老年人常见的损伤，由于合并骨质疏松和骨折不稳定，内固定常存在固定不牢，负重早易致骨结构破坏、髋内翻畸形愈合，卧床时间长并发症多等问题，本院2007年1月～2010年10月采用长柄双动人工股骨头置换治疗老年合并骨质疏松的不稳定粉碎性股骨粗隆间骨折31例患者，术后让患者早期下床，迅速恢复髋关节功能、减少长期卧床并发症等，取得良好效果。现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　 本组31例患