【摘要】 目的探讨一期人工股骨头置换治疗高危老年不稳定股骨粗隆间骨折的疗效。方法 2005年5月～2009年10月,收治合并骨质疏松老年高危不稳定股骨粗隆间骨折病人32例。按照Evens分型,ⅢA型11例、ⅢB型15例、Ⅳ型6例,均采用一期骨水泥型人工股骨头置换术。结果所有患者手术顺利,术后3例出现患肢深静脉血栓形成,1例出现精神症状,1例患髋疼痛,经对症治疗症状基本缓解。无髋关节脱位病例,未发生肺部感染、泌尿系感染及心肌梗塞等并发症。32例均获得8～25个月随访,平均13.2个月。术后Harris评分:优26例,良2例,可4例,优良率为87.5%。结论人工股骨头置换是治疗合并骨质疏松的高龄老年股骨粗隆间骨折的有效方法,恰当选择手术适应证、围手术期处理积极,术后并发症少,可早期离床活动,显著提高患者的生活质量。更多还原

【Abstract】 Objective To explore the clinical effect of artifical femoral head replacement on the treatment of unstable intertrochanteric fractures in the high risk elderly patients. Methods 32 elderly patients with osteoporosis and unstable intertrochanteric fractures were collected from May 2005 to October 2009. Accoding to the Evens classification,there were 11 cases in type ⅢA,15 cases in ⅢB,6 cases in Ⅳ. All patients were treated with artifical femoral head replacement. Results The surgery of all the patients was successful. Deep vein thrombus formation occurred in 3 cases,mental disorder occurred in one case and the ache occurred in another case after operation. No hip dislocation occurred,no complications such as pulmonary infection,urinary tract infection and myocardial infarction etc. occurred. 32 patients were followed up for 8 ～ 25 months with an average of 13.2 months. Accoding Harris scoring system,the results were excellent in 26 cases,good in 2 cases and medium in 4 cases,and the excellent and good rate was 87.5%. Conclusion Artifical femoral head replacement is an effective way for the treatment of unstable intertrochanteric fractures in elderly patients,as we choose the suitable cases and give them active treatment in perioperative period,the operation has less complications. It makes the patients have early physical exercise and improves the living quality of the patients.更多还原