摘要
目的:探讨人工假体置换治疗高龄股骨转子间不稳定性骨折的疗效及原理。方法:采用人工假体置换手术治疗75岁以上高龄老人(平均82.5岁)不稳定性股骨转子间骨折37例。其中Evans Ⅲ型9例,Ⅳ型23例,Ⅴ型5例。其中30例(81％)合并3种以上并存症,并存症中以心血管疾病为主,其次为糖尿病,脑血管病。结果:本组病例无1例术中或住院期间死亡,平均随访18个月。入院至手术时间5-7d,平均6.5d。手术时间45-80 min,平均60 min,术中输血2-8单位红细胞(平均4单位红细胞)。住院时间20-30 d(平均24 d)。伤口一期愈合,未见感染,松动,脱位者。结论:①人工假体置换治疗高龄股骨转子间不稳定性骨折,具有有效止痛,早期离床,并发症少,死亡率低的优点,疗效令人满意;②术后可负重而没有骨折局部塌陷的危险,利于早期康复;③应严格掌握其适应症,强调围手术期的正确处理。
Objective: To study the mechanisms and clinical effect of hip joint replacement for elder patients with unstable intertrochanteric fractures. Methods: Artificial hip joint replacement was performed in 37 patients aged over 75 years with unstable intertrochanteric fractures, whose mean age was 86.5 years. 9 cases belonged to Evans type Ⅲ, 23 cases belonged to Evans type Ⅳ and 5 cases belonged to Evans type Ⅴ. Besides, 30 cases (81% ) accompanied with more than three preexistant diseases which mainly were cardiovascular disease, diabetes mellitus and cerebrovascular disease. Results: The mean time from admission to operation was 4.5 days, the mean operating time was 60 minutes. The average number of the transfused red blood celis was 2 units. None died in operation. The average followed-up time was 18 months. None had infection, prosthesis loss or dislocation. Conclusion: The effect of the hip joint replacement for elder patients with unstable intertrochanteric fracture is confirmed and there isn't the risk of prosthesis collapse.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2004年第5期558-559,共2页
Chinese Journal of Clinical Anatomy
关键词
股骨转子间
骨折
人工关节
置换
高龄
<Keyword>intertrochanteric fracture
prosthesis
replacement
elder
