人工股骨头置换术治疗高龄非稳定性股骨粗隆间骨折

Prosthetic replacement for femoral head and reserving hip dynamics in the treatment of unstable femoral intertrochanteric fracture in aged patients

关键词:  髋关节动力  股骨粗隆间骨折  人工股骨头  高龄

Key words:  reserving hip dynamics  femoral intertrochanteric fractures  artificial femoral head  aged

摘要:

［目的］探讨保留髋关节动力人工股骨头置换术治疗高龄非稳定性股骨粗隆间骨折的疗效。 ［方法］采用保留髋关节动力人工股骨头置换术治疗高龄非稳定性股骨粗隆间骨折15例，股骨头采用骨水泥型普通双极人工股骨头，采用保留髋动力：大粗隆及小粗隆骨折钢丝固定；股骨距缺损采用骨水泥填充；基底部完整者，股骨颈截骨变粗隆间骨折为股骨颈骨折，保留股骨距，插入人工股骨柄固定。［结果］随访6~24个月，平均15个月，无晚期关节松动、脱位及感染病例，优良率达88%，患者均术后1~2周下床功能锻炼。［结论］采用保留髋关节动力人工股骨头置换术治疗高龄非稳定性股骨粗隆间骨折，对恢复股骨近端解剖，稳定髋关节，使患者术后早期下床，改善高龄患者的生活质量，降低死亡率是一种有效的治疗方法。

Abstract:

［Objective］ To investigate the therapeutic effect of artificial femoral head replacement and reserving hip dynamics in the treatment of unstable femoral intertrochanteric fracture in aged patients.［Methods］ Fifteen patients with unstable femoral intertrochanteric fracture were treated with cement biopolar FHR and hip dynamics were reserved. All of the cases were followed up for 6 to 24 months (mean 15 months). ［Result］ The excellent and good rate was 88% with no joint loosening in late phase and no hip joint dislocation and no infection. Weigh-bearing functional exercises were allowed in 1 to 2 weeks. ［Conclusion］ Reserving hip dynamics femoral head replacement is an effective method to treat unstable femoral neck fracture in aged patients. It is beneficial to keeping hip joint stable, restoring anatomy of femoral head and reducing mortality.