摘要
目的探讨人工半髋置换术治疗高龄髋部骨折患者的特殊要点。方法回顾性分析2008年1月-2010年12月对采用半髋置换治疗的138例高龄髋部骨折患者临床资料。其中男43例，女95例；年龄75～103岁，平均82．8岁。致伤原因：摔伤98例，撞伤32例，扭伤8例。股骨颈骨折84例（Gardenlll型33例，Ⅳ型51例），股骨转子间骨折54例（Jensen—Evans分型：Ⅱ型3例，Ⅲ型6例，Ⅳ型25例，V型18例，R型2例）。术后按Harris评分标准进行随访评价。结果本组术后下床活动时间平均4．5d（3～12d）。平均随访24．4个月（10—45个月），无假体松动、下沉、感染等。术后由于再次外伤，发生1例假体脱位、2例假体远端股骨干骨折。术后6个月Harris评分平均86．8分（52—100分），其中优42例，良59例，可19例，差5例，优良率为80．8％。结论在充分做好术前、术中、术后各项措施的前提下，半髋置换治疗高龄患者髋部骨折是一种较好的方法。
Objective To investigate the key points of treating elder patients with hip fractures by hemiarthroplasty. Methods Clinical data of 138 elder patients with hip fractures undergone hemi- arthroplasty between January 2008 and December 2010 were analyzed retrospectively. There were 43 males and 95 females at mean age of 82.8 years （range, 75-103 years）. Injury causes included fall from height （ n = 98 ）, contusion （ n = 32） and sprain （ n = 8 ）. There were 84 patients with femoral neck frac- tures （33 patients with Garden type Ⅲ, 51 with type Ⅳ ） and 54 patients with intertrochanteric fractures （ three patients of Jensen-Evans type Ⅱ , six with type Ⅲ, 25 with type IV, 18 with type V, two with type R）. Follow-up evaluation was performed using Harris scoring system. Results The ambulation period was average 4.5 days （ range, 3-12 days）. Follow-up was average 24.4 months （ range, 10-45 months） , which presented no loosening, subsidence or infection of prostheses. Due to additional trauma postoperatively, one patient suffered from prosthesis dislocation and two from fractures of distal prosthetic femoral shaft. Harris score at six months postoperatively was average 86. 8 points （range, 52-100 points） , with excellent results in 42 patients, good in 59, fair in 19 and poor in five, with excellence rate of 80.8%. Conclusion With full accomplishment of peri-, intra- and post-operative measures, hemi- arthroplasty is a suitable choice for treating hip fractures in the elderly patients.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2012年第11期1001-1005,共5页
Chinese Journal of Trauma
关键词
髋骨折
关节成形术
置换
髋
骨质疏松
高龄
Hip fractures
Arthroplasty, replacement, hip
Osteoporosis
Aged
