摘要
目的 研究人工髋关节置换术治疗股骨头缺血性坏死合并同侧股骨粗隆间骨折的可行性及临床疗效。方法 回顾性分析自2019-10—2021-03诊治的18例股骨头缺血性坏死合并同侧股骨粗隆间骨折,一期采用生物型加长股骨柄行人工髋关节置换术联合骨折复位内固定术治疗。比较术前与末次随访时患者髋关节功能Harris评分,随访并记录并发症发生情况。骨折愈合情况根据骨折临床愈合标准进行评定;临床疗效根据髋关节功能Harris评分评定。结果 18例均获得随访,随访时间20~36个月,平均32.0个月。术后切口按时换药,均一期愈合并拆线,围手术期未出现心脑血管疾病等并发症。骨折均达到临床愈合,愈合时间3~6个月,平均5.0个月。随访期间均未出现感染、假体松动脱位、假体周围骨折、下肢深静脉血栓形成等并发症,末次随访时所有患者均可独立无辅助行走。本组末次随访时髋关节功能Harris评分为(86.89±4.64)分,较术前(53.11±3.45)分明显提高,差异有统计学意义(P<0.05)。末次随访时临床疗效评价:优10例,良6例,可2例,优良率为88.9%。结论 一期人工髋关节置换术联合骨折复位内固定治疗股骨头缺血性坏死合并同侧股骨粗隆间骨折临床可行,疗效满意;股骨侧假体建议选择生物型全涂层加长股骨柄假体,初始稳定性好,同时具有骨折固定作用。
Objective To research the feasibility and clinical effect of artificial hip replacement in the treatment of the femoral head osteonecrosis combined with ipsilateral femoral intertrochanteric fractures.Methods A retrospective analysis was per⁃formed on 18 patients with avascular necrosis of femoral head combined with ipsilateral femoral intertrochanteric fractures from October 2019 to March 2021.One-stage artificial hip replacement combined with fracture reduction and internal fixation was performed with the biologically lengthened stem.The Harris score of hip function was compared preoperatively and at the final follow-up,and complications were recorded during the follow-up.Fracture-healing was evaluated according to the clinical frac⁃ture-healing criteria.Clinical efficacy was assessed according to the Harris score of hip function.Results All the 18 cases were followed up for 20 to 36 months(mean,32.0 months).The incision dressing changes were on time,the incisions healed and stitches were taken out in one stage,and there were no complications such as cardiovascular and cerebrovascular diseases in perioperative period.All fractures reached clinical healing with the healing time of(3-6)months,and the average of 5.0 months.There were no complications such as infection,prosthesis loosening and dislocation,periprosthesis fracture,and deep venous thrombosis of lower limbs during follow-up.All patients could walk independently without assistance at the final follow-up.The Harris score of hip function at the final follow-up was(86.89±4.64),which was significantly higher than that before operation(53.11±3.45),and the difference was statistically significant(P<0.05).At the final follow-up,the clinical efficacy was excellent in 10 cases,good in 6 cases,fair in 2 cases,and the excellent and good rate was 88.9%.Conclusion One-stage hip arthroplas⁃ty combined with fracture reduction and internal fixation in the treatment of avascular necrosis of femoral head combined with ipsilateral femoral intertrochanteric fractur
作者
毕红宾
杨亚丽
李岩
范华雨
李哲
邢庆胜
BI Hongbin;YANG Yali;LI Yan;FAN Huayu;LI Zhe;XING Qingsheng(Department of hip,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Zhengzhou,Henan 450008,China;不详)
出处
《中国骨与关节损伤杂志》
2024年第2期124-127,共4页
Chinese Journal of Bone and Joint Injury
基金
河南省中医药科学研究专项课题(2021JDZX2133)。
关键词
股骨头缺血性坏死
股骨粗隆间骨折
人工髋关节置换术
内固定
Osteonecrosis of the femoral head
Intertrochanteric fracture
Artificial hip replacement
Internal fixation
