【摘要】 目的寻找(探索)股骨颈骨折人工股骨头置换术后防止假体松动下沉而引起的髋部疼痛的治疗方法。方法将38例骨质疏松性股骨颈骨折行人工股骨头置换术后患者分成两组,每组19例,一组术后给予治疗骨质疏松的药物,即益钙宁20 U/支,每周1支,肌注。维生素D3(阿法骨化醇)1.0μg/日,口服。钙尔奇D 600 mg/片,每日1片,口服。另一组不给治疗骨质疏松的药物。术后一年随访,有无髋部疼痛和再发骨折。结果给予药物治疗组只有一例因股骨头型号太大而疼痛。拍双髋X光片见骨密度与手术时拍的X光片比较无明显变化。亦无假体松动和下沉现象,更无再次骨折的发生。没有给治疗骨质疏松药物组19例髋关节皆有不同程度的疼痛;双髋X光片见骨密度减低,而且假体松动下沉。还有两例发生再次骨折。结论 老年人骨折手术后必须同时给予治疗骨质疏松的药物,才能防止骨质疏松的发展及并发症的发生。更多还原

【Abstract】 Objective To explore the treatment strategy for the hip pain caused by prosthesis sinking and loosening after artificial femoral head replacement of femoral neck fracture.Methods Thirty-eight patients with osteoporotic femoral neck fractures after femoral head replacement were divided into two groups,19 cases each.Patients in group A were treated with anti-osteoporosis drug: elcatonin 20 IU per week,vitamin D3(alfacalcidol) 1.0 μg/day,and Caltrate D 600 mg/day.Patients in group B were not treated with anti-osteoporosis drugs.Hip pain and recurrent fractures were checked during one year follow-up.Results In group A,only one patient had hip pain due to the over size of the femoral head model.X-ray examination showed no significant change in bone mineral density before and after surgery.No prosthesis sinking or loosening and no recurrent fractures were found.In group B,all of the 19 patients had different degrees of hip pain.X-ray examination of both hips showed reduced bone mineral density and sinking and loosening of the prosthesis.Two recurrent fractures occurred.Conclusion Elder patients with fracture must be given anti-osteoporosis drugs after surgery to prevent the development of osteoporosis and the complications.更多还原