人工股骨头置换术治疗高龄股骨粗隆间骨折的临床研究

目的分析人工股骨头置换术治疗高龄骨质疏松性股骨粗隆间不稳定骨折的适应证及疗效。方法2004年11月至2008年5月本院收治187例高龄股骨粗隆间骨折患者，从中选取伴有骨质疏松性股骨粗隆间不稳定骨折患者22例（Evans分型Ⅲ型9例、Ⅳ型13N）行人工股骨头置换术治疗。对手术时间、术中失血量、住院时间、卧床时间、并发症以及患侧髋关节功能5项临床指标进行统计学分析。结果17例患者获得随访，随访时间5个月至3年，平均2．2年，提示假体位置良好，无明显下沉松动，股骨粗隆部骨折均愈合，无一例发生关节脱位和假体周围骨折。结论在特定适应证下，人工股骨头置换术可作为临床治疗高龄骨质疏松性股骨粗隆间不稳定骨折一种选择。

Artificial femoral head replacement for femoral intertrochanteric fractures in senile patients

Objective To study the indications and effect of artificial femoral head replacement for osteoporotic intertrochanteric fractures in senile patients. Methods From December 2004 to March 2008, 187 senile patients with intertrochanteric fractures were admitted for treatment. Twenty-two were treated with artificial femoral head replacement. The cases were cliassified as Evans Ⅲ（n=9） and Evans Ⅳ（n=13）. The data of operation time, blood loss, hospitalization time, in-bed time, complications, and the function of the affected hip were recorded for statistical analysis. Results Seventeenpatients were followed up for was well positioned, without subsidence or loosening. The 5 to 36 months, 2.2 in average. The artificial femoral head fracture healed. There is no dislocation ofjiont or circumprosthesis fracture for seventeen cases. Conclusions With specific indcations, artificial femoral head replacement is an treatment option for osteoporotic unstable intertrochanteric fractures in senile patients.