双极人工股骨头治疗老年帕金森患者股骨颈骨折

背景:帕金森患者由于肌力不平衡等原因更容易跌倒,发生股骨颈骨折的风险高。目的:观察双极人工股骨头置换对老年帕金森病合并股骨颈骨折患者的治疗效果。方法:回顾分析14例帕金森病合并股骨颈骨折行双极人工股骨头置换患者的临床资料,共14髋,Hoehn-Yahr分级Ⅰ期3例,Ⅱ期4例,Ⅲ期5例,Ⅳ期2例,置换时年龄62～83岁。采用Harris评分、Fugl-Meyer量表及统一帕金森病评定量表相结合的方法进行随访。结果与结论:随访1～6年,14例患者置换后Harris评分平均85.4分,优于置换前平均22.3分(P<0.05),Fugl-Meyer评分置换后平均81.6分,优于置换前平均52.5分(P<0.05),统一帕金森病评定量表评分置换前后差异无显著性意义,帕金森病情控制稳定。无关节松动、脱位等并发症发生。早中期随访结果显示,在有效神经内科药物控制下,双极人工股骨头置换是一种安全、有效治疗Hoehn-YahrⅠ～Ⅳ期帕金森病合并股骨颈骨折患者的方法,置换后髋关节功能与帕金森病病情控制相关。

Bipolar femoral head replacement for the treatment of femoral neck fractures in elder Parkinson's disease patients

BACKGROUND:Due to the muscle imbalance outcomes,Parkinson’s patients are easy to fall and have a high risk of femoral neck fracture.OBJECTIVE:To explore the treatment outcomes of bipolar femoral head replacement for the femoral neck fractures in elder Parkinson’s patients METHODS:A retrospective analysis was carried out on the clinical data of the 14 Parkinson’s disease patients of femoral neck fractures,a total of 14 hips,who were treated with bipolar femoral head replacement.The patients were divided into three phases by Hoehn-Yahr classification,3 cases in Ⅰ phase,4 cases in Ⅱ phase,5 cases in Ⅲ phase and 2 cases in Ⅳ phase.The average surgery age was 62 to 83 years old.The Harris score,Fugl-Meyer scale and Unified Parkinson’s Disease Rating Scale score were used as follow-up judgment.RESULTS AND CONCLUSION:The average follow-up time was 1 to 6 years.Harris score of 14 patients was postoperatively 85.4 better than preoperatively 22.3(P < 0.05),Fugl-Meyer score was postoperatively 81.6 better than preoperatively 52.5(P < 0.05).There was no significant difference of Unified Parkinson’s Disease Rating Scale score before and after operation,and the Parkinson’s disease controlled stable.No prosthesis loosening,dislocation or other complications.Early and mid-term follow-up showed under the effective medical control of the neurology drugs,bipolar femoral head replacement is a safe and effective treatment of femoral neck fracture for Hoehn-Yahr Ⅰ-Ⅳ Parkinson’s patient.There is relationship between the hip joint function and the control of the Parkinson’s disease after replacement.