生物型长柄人工股骨头假体治疗老年股骨转子间骨折-第三军医大学学报.DOC

生物型长柄人工股骨头治疗老年股骨转子间不稳定型骨折27例临床分析 郭珊成,张 峡,郝 勇 （400037 重庆,第三军医大学新桥医院骨科) [摘要] 目的 评价应用非骨水泥型长柄双极股骨头置换治疗高龄患者不稳定粗隆间骨折的方法及疗效。方法 2004年7月至2007年9月我院收治27例老年不稳定粗隆间骨折患者，男性12例,女性15例,年龄71～91岁，均为股骨转子间粉碎性骨折，骨折类型按Evans-Jenson分类，ⅡA：9例，ⅡB：11例，Ⅲ：7例。均行加长柄双极股骨头置换。结果 本组手术过程顺利，住院期间无人工关节脱位、感染及下肢深静脉血栓形成等并发症。门诊复查随访期间1例死于慢性支气管炎呼吸衰竭。3例出院后未获随访，23例随访时间6～37个月,平均19个月,获得随访的患者中关节脱位，人工假体均无松动、下沉及断裂。最后1次随访时Harris评分平均为84.6分。结论 加长柄双极股骨头置换治疗高龄患者股骨粗隆间不稳定骨折创伤小,并发症少，是一种安全、有效的治疗方法。 [关键词] 髋假体；关节成形术, 置换, 髋；髋骨折；老年人 [中图法分类号] [文献标志码] A Treatment of elderly femoral unstable intertrochanteric fractures with uncemented long stem bipolar prosthetic prosthesis Guo Shancheng, Zhang Xia, Hao Yong (Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037,China) [Abstract] Objective To evaluate the results of uncemented long stem bipolar prosthetic prosthesis for the management of unstable intertrochanteric fractures in the elderly. Methods 　From July 2004 to Septenber 2007, 27 elderly patients with unstable intertrochanteric fractures were treated with uncemented long stem bipolar prosthetic prosthesis.There were 9 cases with type ⅡA of the fracture by Evans-Jenson classification , ⅡB in 11 cases , Ⅲ in 7 cases. Results The operative is all right in All patients，no case happened dislocation, infection and deep venous thrombosis of lower limbs.3 patients were lost in follow-up ,one patient died due to sever respiratory failure during the follow-up period .Followed-up period ranged from 6 months to 37 months (average 19 months) in 23 cases .No dislocation, infection, loose, sink of the prosthesis was found in all the cases that were followed-up. Harris score reached 84.6. Conclusion uncemented long-stem bipolar prosthetic prosthesis replacement for management of unstable intertrochanteric fractures in elderly is safety,effective methods，and it is desirable and less complications. [Key words] hip prosthesis；arthroplasty, replacement, hip；hip fractures；aged