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51.
52.
人工股骨头置换术治疗高龄非稳定性股骨转子间骨折 总被引:14,自引:3,他引:11
目的探讨高龄患者非稳定性股骨转子间骨折行人工股骨头置换术的临床疗效。方法本组74例,年龄75~89岁,平均80.3岁;骨折类型按Evans分类:ⅢA型31例,ⅢB型24例,Ⅳ型19例。其中3例为经内固定治疗失败病例,合并内科疾病者69例,在相关内科协同治疗后行双极骨水泥型人工股骨头置换术,术后早期进行康复锻炼。结果74例都顺利通过手术,住院期间无死亡病例;72例获得随访,随访时间3~16个月,平均9.2个月;无一例出现畸形,髋关节功能接近或恢复到受伤前水平,生活可自理;2例于出院后5个月、11个月死于其他疾病。结论人工股骨头置换术治疗高龄非稳定性股骨转子间骨折是一种效果确切的治疗方法,操作简单、创伤小、卧床时间短、并发症低、死亡率低,提高了高龄患者的生活质量。 相似文献
53.
F. Specchiulli R. Gabrieli D. Borsetti V. Di Carlo 《Journal of orthopaedics and traumatology》2007,8(3):123-127
We examined the clinical and radiographic results of 93 patients affected by knee arthritis or osteonecrosis subjected to
unilateral cementless mobile-bearing total knee arthroplasty with the LCS prothesis (Depuy/Johnson & Johnson). The mean follow-up
was 9.5 years (range, 7–12 years). Clinical evaluation was performed using the Knee Society rating system, while radiographic
evaluation was done according to the Knee Society roentgenographic system. At the latest follow-up, the mean knee score was
87 points: the functional score improved from 40 to 90. Radiolucent lines were small and not progressive. The implant survival
at 12 years was 88%. Six knees (7%) required revision for implant-related problems. We conclude that the mobile-bearing prosthesis
is a successful device even at long-term follow-up. 相似文献
54.
Javier Alegre-López José Cordero-Guevara José L. Alonso-Valdivielso Julia Fernández-Melón 《Osteoporosis international》2005,16(7):729-736
Hip fracture results in excess mortality and functional disability. This study sought to identify predictors of mortality and limited functional ability 1 year after hip fracture. We conducted a 1-year follow-up of a prospective population-based inception cohort of 218 hip fracture patients who had been consecutively admitted and discharged from hospital during the previous year. Mortality was observed to be independently associated with poor mental status (relative risk [RR]=6.96; 95% confidence interval [95% CI], 1.73–28.00), prefracture limited functional ability (RR=4.35; 95% CI, 1.32–14.36), institutionalized disposition at discharge (RR=2.92; 95% CI, 1.02–8.38), and male gender (RR=2.44; 95% CI, 1.01–5.93). Independent predictors of limited functional ability were prefracture functional disability (RR=34.14; 95% CI, 3.13–372.33), poor mental status (RR=9.71; 95% CI, 1.57–59.82), age >80 years (RR=4.03; 95% CI, 1.48–11.00), and female gender (RR=3.57; 95% CI, 0.08–0.98). On discharge, special attention and care should thus be given to all patients displaying any of the above predictive factors. 相似文献
55.
目的 :探讨起搏器高度依赖性患者起搏器置换方法与疗效。 方法 :对 8例起搏器高度依赖性患者 ,在起搏器与电极的接口松解前 ,应用在体起搏器间断接触法 ,使自身逸搏心律得已恢复 ,然后再行松解接口以及必要的起搏参数测试。 结果 :起搏器离体次数为 3~ 7(5± 2 )次 ,最长逸搏间期为 3.38~ 6 .2 0 (4.5 1± 1.11)s,自身逸搏心率为 30~ 4 3(38± 5 )次 /min ,均顺利完成起搏器置换。 结论 :在体起搏器间断接触法切实可行 ,能够明显提高起搏器高度依赖性患者起搏器置换的安全性 相似文献
56.
目的研究云南白药在围术期对全髋关节置换术术中出血量及术后引流量的影响。方法2006至2008年我科收治的股骨颈骨折行全髋关节置换术60例,随机分成两组,分别服用云南白药胶囊和空胶囊;术前术后测定凝血酶原时间(PT),记录全部病人术中出血量及术后24 h引流量。结果实验组和对照组病人的凝血酶原时间(PT)差异有统计学意义(P<0.01);试验组的术中出血量、术后24 h引流量分别为(380±78)ml(、336±77)ml,较对照组(481±77)ml(、418±68)ml明显减少,差异具有统计学意义(P<0.01)。结论云南白药胶囊能够明显减少全髋关节置换术围术期出血量。 相似文献
57.
P. Rossi F. Castoldi R. Rossi F. Caranzano M. Baronetti F. Dettoni 《Journal of orthopaedics and traumatology》2007,8(3):157-163
Surgery passes through a continuous evolution, thanks to the introduction of new technologies and techniques. Tissue-sparing
surgery is a concept introduced in the last years to address prosthetic surgery to a more conservative fashion. We discuss
the TSS decalogue with a critical eye, pointing out how traditional surgery is evolving in accordance with TSS statements.
Proceedings of the Consensus Conference “TSS in hip and knee replacement”, Rapallo, Italy, 22–24 June 2006 相似文献
58.
François Lavigne P. Culpan T. Judet P. Piriou 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(5):321-325
Objective Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described
to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although
mechanical and wound complications have been reported.
Materials and methods We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised.
Results The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated
with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to
102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred
in one patient; there were no other cases with a postoperative extension lag.
Conclusion In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure
without compromising the clinical and radiographic outcome. 相似文献
59.
C. Delaunay 《Interactive Surgery》2007,2(3-4):174-177
Assessment of possible low-wear with some former metal-on-metal (MoM) total hip arthroplasties (THA) led to the reintroduction
of metallic bearings in the late 80’s. The author reports on two studies of Metasul-28 mm cementless THA. In the first one
in a general population, impingement has been the main cause of osteolysis and Co level survey has been a good indicator of
Metasul bearing behaviour. In the second study, in a group of 83 less than 50-year-old and active patients, Metasul bearings
showed good wear resistance at 7.2 years mean follow-up. In both studies, no general toxic effect could have been detected
thus far. According to the current knowledge, it is always reasonable to expect low-wear and better THA longevity with use
of MoM bearings under the following conditions: 1) use of a CoCr alloy with high carbide concentration; 2) reduce impingement
risk (head without sleeve, slimmer as possible neck, perfectly adapted Morse cone from the same manufacturer, well — oriented
components); and 3) prefer cementless acetabular fixation. 相似文献
60.
老年新鲜股骨颈骨折治疗方法探讨 总被引:1,自引:0,他引:1
目的 探讨老年新鲜股骨颈骨折的术式选择。方法 回顾性分析217例60岁以上新鲜股骨颈骨折,分别采用单钉固定(46例)、多针固定(37例)、AO空心钉固定(79例)、人工髋关节置换(55例)4种方法,对比骨折愈合率、股骨头坏死率、髋关节功能恢复优良率。结果 内固定组骨折愈合率83.3%(140/162),股骨头坏死率19.1%(31/162),髋关节功能优良率75.9%(123/162)。其中空心钉组骨折愈合率94.9%(75/79),股骨头坏死率6.3%(5/79),髋关节功能优良率91.1%(72/79)。人工关节组髋关节功能优良率89.1%(49/55)。结论 内固定手术对老年新鲜股骨颈骨折有意义,AO空心钉固定操作简单,骨折愈合率高,可作首选内固定。人工髋关节置换应严格掌握适应证。 相似文献