摘要
目的通过中期的随访观察，探讨人工关节置换术治疗高龄股骨粗隆间不稳定性骨折的可行性。方法对2004-01～2009-08于广西壮族自治区人民医院住院行人工关节置换手术并获得随访的38例（38髋）高龄股骨粗隆间不稳定型骨折患者进行回顾性分析，评判其手术疗效。结果所有患者均安全度过围手术期，随访时间平均为（6．2±1．2）年，手术平均出血量为（444．7±304．3）ml；术后开始下床时间平均为（4．7±3．4）d；术后发生脱位1例，术后4年1例出现假体松动，术后5年发生髋臼磨损1例。1年病死率为7．9％，5年病死率为34．2％。存活患者术后3个月、1年、5年的平均Harris评分分别为（77．8±7．5）分、（85．1±6．4）分和（81．2±7．2）分；优良率分别为63．2％、85．7％和80．0％。结论人工关节置换术治疗高龄不稳定型股骨粗隆间骨折具有下床活动早、并发症少、病死率低的特点，早期即可获得良好的关节功能恢复，并于中期仍可获得满意的疗效，对于高龄不稳定型股骨粗隆间骨折是一种可靠的治疗方式。
Objective To evaluate the clinical results of the hip replacement for treating the unstable intertrochanteric fractures in the elderly patients. Methods Thirty-eight elderly patients( aged 75 and above) with unstable intertrochanteric fractures were treated by the hip arthroplasty in our hospital from January 2004 to August 2009.All the patients were followed up to assess the effects. Results All of the patients were followed up for( 6. 2 ± 1. 2)years,without dead cases during perioperation. The one-year mortality was 7. 9% and the five-year mortality was34. 2%. The intraoperative blood loss was( 444. 7 ± 304. 3) ml in average and the mean time of postoperative activities was( 4. 7 ± 3. 4) d. Artificial joint dislocation happened in one case and prosthesis subsidence in one case when the patients were followed up for four years after the surgery. Acetabular erosion was found in one case over the fiveyears follow-up. The Harris scores were( 77. 8 ± 7. 5),( 85. 1 ± 6. 4) and( 81. 2 ± 7. 2) in average respectively after three months,one year and five years of the operation and the excellent and good rates were respectively 63. 2%,85. 7% and 80. 0%. Conclusion The hip replacement for the unstable intertrochanteric fractures in the elderly patients can shorten the time in bed and reduce the complications. It may benefit the patients with earlier function recovery,and keep long-term of good curative effect.
出处
《中国临床新医学》
2015年第10期906-909,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广西卫计委科研课题(编号:Z2012309)
