APL非骨水泥柄人工髋关节置换治疗老年人股骨粗隆间骨折

目的：总结采用APL非骨水泥柄人工髋关节假体置换治疗老年股骨粗隆间骨折的疗效。方法：2011年10月，2014年1月，我们采用施乐辉APT。柄人工髋关节置换术治疗老年人股骨粗隆间骨折49例，男21例，女28例；摔倒32例，车祸12例，高处跌落5例。按evans分型，Ⅲ型20例，Ⅳ型24例，V型5例。49例病人中30例患有多种内科疾患，如高血压、冠心病、糖尿病、脑血栓、慢性支气管炎肺气肿、肺心病等，术后随访时间2个月～2年，平均17个月。结果：术后x片示假体位置良好，且髋关节恢复正常活动，全部病人均如期出院，在院期间均无严重并发症出现。出院后随访，49例病人中无髋关节脱位、松动及感染，均保留了行走功能，大部分（36例）达到了骨折前的行走水平。结论：APL柄非骨水泥柄人工假体置换在治疗尤其是老年人不稳定股骨粗隆间骨折方面，短期在死亡率，并发症，早期康复方面具有明显优势

APL non bone cement handle artificial hip joint replacement for the treatment of intertrochanteric fracture in the elder

Objective： To summarize the effect of APL non bone cement handle artificial hip joint replace- ment for the treatment of intertrochanterie fracture in the elder. Methods： From October 2011 to January 2014, the Smith ＆ Nephew APL non bone cement handle artificial hip joint replacement was used for treat- ment of 49 patients （21 male and 28 female） with intertrochanteric fracture in the elder. Among them, fall in 32, traffic accident in 12 and fall from high in 5 cases. According to Evans classification, 20, 24 and 5 cases were separately diagnosed as type Ⅲ, Ⅳ and Ⅴ, 30 of 49 patients suffer from a variety of medical problems, such as hypertension, coronary heart disease, diabetes, cerebral thrombosis, chronic bronchitis, em- physema or pulmonary heart disease, et al. Postoperative follow-up time ranged from 2 months to 2 years （average 17 months）. Results： The postoperative X-ray showed that the location of the prosthesis was good, with a normal hip activity, all the patients discharged from hospital as schedule, no serious complications occurred during hospitalization. Post-discharge follow-up showed no dislocation,loosening hip and infection noted in all cases, and 36 patients achieved the same walking level as before the surgery. Conclusion： APL non bone cement handle artificial hip joint replacement for the treatment of intertrochanteric fracture in the elder, has an obvious advantages in mortality, complications and early rehabilitation in the short term.