高龄股骨粗隆间骨折内固定失败后定制型人工股骨头置换治疗的临床研究

目的 探讨高龄患者股骨粗隆间骨折内固定失败后采用定制型人工股骨头置换术治疗的效果.方法 2004年1月～2008年6月收治粗隆间骨折内固定失败的患者12例,男5例,女7例,年龄75～90岁,平均82岁.12例患者均采用定制型的骨水泥型假体置换治疗.术后观察患者生活自理能力及手术并发症的发生情况.结果 所有患者顺利实施手术,时间约60～90min,无骨水泥方面的并发症;术后均顺利渡过围手术期,术前疼痛症状消失.随访6～18个月无伤口感染、假体脱位、下肢深静脉栓塞等并发症;随访期间未出现假体松动、断裂方面的并发症,髋关节功能良好,效果满意.结论 高龄患者股骨粗隆间骨折内固定失败后采用定制型假体置换术治疗,术后可以获得较好的功能恢复,减少卧床时间,降低病死率,提高生活质量,疗效较满意.

Clinical Study of Specially Designed Artificial Femoral Head Replacement for the Treatment of Failure of Internal Fixation of the Femoral Intertrochanteric Fractures in the Elderly

Objective To evaluate the clinical results of specially designed artificial femoral head replacement for the treatment of failure of internal fixation of femoral intertrochanteric fracture in the elderly. Methods From January 2004 to June 2008,12 patients failed to internal fixation ＇after intertrochanteric fractures were treated,including five males and 7 females （ age,75 - 90 ; average, 82 years old ）. All patients were treated with specially designed artificial femoral head replacement. After the operation, the self-care ability of patients and the complications of the operation were observed. Results All operations were done successfully in 60 to 90 minutes, without any bone cement associated complication. All patients passed through the operation successfully and their pain disappeared gradually. After 6 - 18 months fol- low-up,there was no infection,prosthesis dislocation,bed sore or deep veins of lower limb complications,meanwhile neither cinch nor breakage of prosthesis was found during follow-up period. Conclusion Specially designed artificial femoral head replaeement is an effective meth- od for the treatment of failure of internal fixation of femoral intertrochanteric fractures in the elderly patients,which can decrease time in bed, reduce case fatality rate and improve life quality and meet a satisfied outcome.