摘要
【目的】探讨转子间骨折内固定术后创伤性关节炎的全髋置换术治疗的疗效。【方法】2009年1月至2016年3月,转子间骨折内固定术后内固定失败或畸形愈合所致创伤性关节炎35例,男18例,女17例;年龄49~86岁,平均68.5岁;均采用全髋关节置换术。其中股骨侧采用近端固定柄假体13例,远端固定柄10例,延长柄假体12例。【结果】经3~65个月随访,髋关节HSS评分平均术前44.1分(31~65),提高到术后82.5(58~94)。髋关节术后功能的优良率91.4%。术后未出现脱位和深部感染。2例股骨柄侧分别出现了5 mm和10 mm下沉,但未见假体的明显松动。【结论】转子间骨折内固定术后创伤性关节炎,采用全髋置换术治疗,股骨侧因骨质硬化或骨缺损,采用远端固定柄假体,并注重重建大转子,可取得良好的临床疗效。
【Objective】To investigate the efficacy of total hip arthroplasty（THA）on the treatment of traumatic arthritis that caused by internal fixation failures of intertrochanteric fractures.【Methods】During January 2009 and March 2016,35 cases of traumatic arthritis（male：18 cases;female17 cases;49 ~ 86 years old,with an average age of 68.5 years）caused by internal fixation failures or malunion of intertrochanteric fractures,were undergo THA.Among 35 cases,13 cases were performed with the proximal femoral fixation stems,10 cases were with distal fixation stems,and 12 cases were with extended stems.【Results】With 3 ~ 65 months follow-up,the hip joint HSS score was elevated from 44.1（31 ~ 65）preoperative to 82.5（58 ~ 94）postoperative without obvious loosening.No postoperative deep infectionwas found.The femoral stems in 2 cases were found to sink 5 mm and 10 mm,respectively.No obvious prosthesis loosening was found.Taken together,the satisfaction rate of THA on the joint function of traumatic arthritis was91.4%.【Conclusion】Total hip arthroplasty is recommended as an effective approach for treating traumatic arthritis caused by internal fixation failures of intertrochanteric fractures.Distal fixed prosthesis was recommended due to bone sclerosis or defects of proximal femur.Coupled with emphasis on reconstruction of the greater trochanter,good therapeutic effects could be achieved.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2017年第2期273-277,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
国家自然科学基金(81672224)
广东省医学科研基金(A2016502)
关键词
转子间骨折
内固定
创伤性关节炎
全髋置换术
股骨柄假体
intertrochanteric fracture
internal fixation
traumatic arthritis
total hip arthroplasty
femoral prosthesis
