人工关节置换治疗老年股骨粗隆部不稳定骨折

目的 分析和评价应用人工关节置换术治疗老年股骨粗隆部不稳定骨折的方法及疗效.方法 回顾性分析应用人工髋关节置换手术治疗老年股骨粗隆部不稳定骨折并有完整资料者32例,男18例,女14例,年龄68～86岁,平均73.6岁.骨折类型按Tronzo和Evans分类:Ⅲa型7例,Ⅲb型12例,Ⅳ型13例.结果 32例平均随访时间14个月(9～68个月),无一例感染,无关节严重疼痛、功能障碍或深静脉血栓(DVT)发生,无术后关节早期脱位,无假体断裂、下沉等并发症发生,无一例因手术并发症死亡.Harris评分平均由术前28.4分恢复到术后83.6分.结论 人工髋关节置换术是一种治疗老年股骨粗隆部不稳定骨折的安全有效方法之一,但应严格掌握其手术适应证.Abstract：Objective To study and evaluate the curative result of artificial joint replacement in treatment of unstable intertrochanteric fractures in the eldely. Methods A retrospective analysis of 32 consecutive elderly cases of hip replacement for unstable intertrochanteric fractures was conducted, 32 cases had an average age of 73.6 years (ranged from 68 years to 86 years).Eighteen of 32 cases were male, 14 of 32 cases were female. Type Ⅲa of the fracture by Tronzo-Evans classification were in 7 cases, Ⅲb in 12 cases, Ⅳ in 13 cases.Results Follow-up period from 9 to 68 months (mean 14 months) in 32 cases. The operations succeeded in 32 cases, with no complication such as wound infection, relaxed, joint severe pain, hip dislocation or prcsthesis breakage, and none happened to DVT, none shock or died in operation. The Harris score of patients increased from 28.4 preoperatively to 83.6 postoperatively.Conclusions Hip replacement in treatment of unstable intertrochanteric fractures in the elderly is a satisfactory and safe way. So satisfactory and desirable results can be obtained from the indication controlled.

Artificial joint replacement in treatment of unstable intertrochanteric fractures in the elderly