翻修柄人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折

目的:观察翻修柄人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折的效果。方法:自2007年9月至2011年1月,采用翻修柄人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折患者32例,其中男11例,女21例;年龄80~98岁,平均83.8岁;受伤至就诊时间4 h^14 d。骨折采用Evans-Jensen分型,Ⅱa型6例,Ⅱb型20例,Ⅲ型6例。对术后死亡率、并发症发生率及Harris髋关节功能进行对比分析以评价疗效。结果:所有患者获随访,均未见脱位。6例在术后1年3个月~4年6个月死亡。术后6个月恢复独立行走24例,扶拐或助行器行走8例。Harris髋关节评分平均(91.56±2.96)分,优28例,良4例。9例发生并发症,经治疗后痊愈。结论:翻修柄人工股骨头置换是高龄不稳定型股骨粗隆间骨折的一种积极可靠的治疗措施。

Renovation stem revision femoral head arthroplasty for unstable intertrochanteric fracture in the elderly

To observe clinical efficacy of renovation stem revision femoral head arthroplasty for the treatment of unstable intertroehanteric fracture in the elderly. Methods：Totally 32 elderly patients with unstable intertroehanteric frac- ture were treated with renovation stem revision femoral head arthroplasty from September 2007 to January 2011. There were 11 males and 21 females with an average age of 83.8 （ranged ,80 to 98） years old ,the time from injury to hospital ranged from 4 h to 14 days. According to Evans-Jensen classification ,6 cases were type H a,20 cases were type I1 b ,and 6 cases were type HI. Postoperative mortality, complication rates and Harris hip function score were compared and analyzed to evaluate curative ef fect. Results：All patients were followed up and no dislocation occurred. Six patients were died during 15 months and 4.5 years;24 cases reeoved to independent wakling at 6 months after operation, and 8 cases walked with stick and walker. The av erage Harris hip joint function score were （91.56＋2.96）, 28 cases got excellent results and 4 cases good. Nine cases occurred complications and healed after treatment.Conclusion：Renovation stem revision femoral head arthroplasty is a active and reli able method in treating unstable intertrochanteric fracture in the elderly.