摘要
目的将高龄股骨转子间骨折的人工股骨头置换术与高龄股骨颈骨折行人工股骨头置换术的临床结果相比较,探讨人工股骨头置换术治疗高龄股骨转子间骨折的经验、适应证以及早中期随访结果。方法对1996年8月～2002年4月间行人工股骨头置换术治疗的80岁以上新鲜的40例股骨转子间骨折和45例股骨颈骨折高龄患者进行回顾性分析,将随访结果进行比较和评估,并进行统计学分析。结果两组随访时间均为3～7年,转子间骨折组平均4．6年,股骨颈骨折组平均5．5年。两组在住院时间、术中出血量、术后引流量、术后扶拐下地时间和术后早期并发症等方面比较,差异无显著性意义(P＞0．05)。转子间骨折组比股骨颈骨折组手术时间长,术后出现双下肢不等长的可能性高,差异有显著性意义(P＜0．05)。末次随访的Harris髋关节评分,两组比较差异无显著性意义(P＞0．05)。术后并发症情况：在深静脉血栓、髋关节间隙变化、疼痛、假体柄松动下沉等方面,两组比较差异无显著性意义(P＞0．05)。两组假体翻修率差异无显著性意义(P＞0．05),均未见因髋臼磨损而发生髋臼内陷甚至中心性脱位。结论使用标准骨水泥型股骨假体,股骨转子间骨折行人工股骨头置换术取得了与股骨颈骨折行人工股骨头置换术相同的临床效果。
Objective To compare the clinical results of femoral head replacement for femoral intertrochantefic fractures and femoral neck fractures in aged patients. Methods Forty cases of femoral intertrochanteric fractures and 45 cases of femoral neck fractures （aged over 80 years） underwent femoral head replacement from August 1996 to April 2002 in our department. The clinical results of the two groups were retrospectively compared and analyzed statistically. Their follow-up periods, ranging from 3 to 7 years, averaged 4.6 years in the intertrochanteric fracture group and 5.5 years in the neck fracture group. Results The differences in time of hospitalization, perioperative blood loss, postoperative drainage, ambulation time, early complications between the two groups were of no statistical significance （ P 〉 0. 05）. The differences in operation time and inequality in leg length after operation between the two groups were of statistical significance （ P 〈 0. 05）. The operation time was longer and more limb-length inequality occurred in the intertrochanteric fracture group than in the neck fracture group. There was no significant difference in Harris score at the last follow-up between the two groups. The X-ray at the final follow-up showed that there was insignificant difference in postoperative hip joint space, hip pain, or stem loosening between the two groups （ P 〉 0. 05）. The stem revision incidences were of no statistical significance between the two groups （ P 〉 0. 05）. The two groups reported no acetabular protrusion. Conclusion With standard cemented prostheses, femoral head replacements can achieve as similar functional outcomes for patients with intertrochanteric fractures as for those with femoral neck fractures,
出处
《中华创伤骨科杂志》
CAS
CSCD
2006年第8期725-729,共5页
Chinese Journal of Orthopaedic Trauma
关键词
股骨转子间骨折
高龄
关节成形术
置换
髋
Femoral intertrochanteric fracture
Aged
Arthroplasty, replacement, hip
