摘要
背景:目前对不稳定性老年股骨转子间骨折是采用骨水泥型还是生物型半髋置换治疗还存在争论,因此有必要进一步研究此两种方法的有效性和安全性的差异。目的:比较生物型与骨水泥型半髋置换治疗老年不稳定性股骨转子间骨折临床疗效差异。方法:回顾性分析枣庄矿业集团中心医院骨科2009年5月至2014年5月间收治的93例老年不稳定性股骨转子间骨折患者的临床资料,根据假体类型不同将患者分为2组,骨水泥组54例采用骨水泥型股骨假体行双极人工股骨头置换,生物组39例采用生物型股骨假体行双极人工股骨头置换。结果与结论:(1)与生物组相比,骨水泥组患者术后引流量、输血量较低(P<0.05),但手术时间较长(P<0.05);(2)两组患者术中出血量、术后离床活动时间、术后住院天数、术后并发症、髋关节功能、术后3个月及1年死亡率差异均无显著性意义(P>0.05);(3)两组患者术后即刻X射线片检查显示,假体位置良好,共10例(骨水泥组3例,生物组7例)患者术后发生假体下沉,但下沉距离均小于3 mm;(4)随访期间未见患者出现异位骨化、假体周围骨溶解及髋臼软骨磨损,共25例(骨水泥组16例、生物组9例)患者在随访期间死亡,假体均无松动,其他患者68例患者随访时间2-7年,平均(4.5±2.3)年,未出现假体松动需要翻修;(5)结果证实,对于老年不稳定性股骨转子间骨折,采用生物型或骨水泥型半髋置换,均可获得满意的疗效,安全可靠,其中骨水泥型假体具有降低术后引流量及输血量的优点。
BACKGROUND： The use of cemented or uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly remains controversial. Therefore, it is necessary to conduct a comparative study on the effectiveness and safety of these two methods. OBJECTIVE： To compare the clinical efficacy of cemented and uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly. METHODS： Clinical data of 93 elderly patients with unstable intertrochanteric fractures in Department of Orthopedics, Shandong Energy Zaozhuang Mining Group General Hospital from May 2009 to May 2014 were analyzed retrospectively All patients were divided into cemented （cemented bipolar hemiarthroplasty for fractures, n=54） and uncemented （uncemented bipolar hemiarthroplasty for fractures, n=39） groups. RESULTS AND CONCLUSION： （1） The amounts of postoperative drainage and blood transfusion in the cemented group were significantly less than those in the uncemented group （P 〈 0.05）, but the operation time was significantly longer （P 〈 0.05）. （2） There were no significant differences in the intraoperative blood loss, ambulation time, hospitalization time, postoperative complications, hip function, and mortality at 3 and 12 months postoperatively between two groups （P 〉 0.05）. （3） Postoperative X-ray showed that all patients had good prosthesis position. There were 10 patients （3 cases in the cemented group, 7 cases in the uncemented group） with postoperative prosthesis subsidence, but all of them were less than 3 ram. （4） None of patients had heterotopic ossification, osteolysis around the prosthesis and acetabular cartilage wear during follow-up. Additionally, 25 patients （16 cases in the cement group, 9 cases in the uncement group） died during follow-up, without prosthesis loosening, and the remaining 68 patients were followed up for 2-7 years, （4.5±2.3） years on average, and none needed revision because of prosthesis loosening. （5） These results indicate that for senile unstable intertrochanteric fractures, both cemented and uncemented hemiarthroplasty Can achieve satisfactory curative effectiveness and exhibits good safety. Notably, the cemented prosthesis has advantages in reducina Postoperative drainaae volume and blood transfusion.
出处
《中国组织工程研究》
CAS
北大核心
2017年第23期3622-3627,共6页
Chinese Journal of Tissue Engineering Research
