人工关节置换治疗高龄不稳定性股骨转子间骨折

目的评价髋关节置换治疗高龄不稳定性股骨转子间骨折的临床疗效。方法49例高龄不稳定性股骨转子间骨折患者，女性30例，男性19例，年龄75-94岁，平均83.5岁。骨折按Tronzo-Evans分型，Ⅲ型28例，Ⅳ型21例。8例合并髋关节骨关节炎采用全髋关节置换术治疗，5例采用特制粗隆柄人工股骨头置换，其余均采用双极人工股骨头置换。结果所有病例术后X线片显示转子间骨折均复位固定良好，假体位置良好。术后48例获得6-48个月随访，平均22个月。Harris评分，优良率85.4％。结论人工关节置换术具有术后功能恢复快、负重活动早，可避免长期卧床并发症等优点，是治疗高龄不稳定性股骨转子间骨折较为合理的手术方法。

Treatment of Unstable Femoral Intertrochanteric Fracture in Elderly Patients with Hip Prosthetic Replacement

Objective To evaluate the clinical using for unstable intertrochanteric fractures in senile patients with hip prosthetic replacement. Methods 49 cases of senile unstable intertrochanteric fractures included 19 males and 30 females,and the average age was 83.5 years （range from 75 to 94 years）. According to Tronzo-Evans type, Ⅲ type 28, Ⅳ type 21.8 cases were treated by total hip replacement ;5 cases by handtailor stem hemiarthroplasties ;all the rest by cemented bipolar hemiarthroplasties. Results X rays of all cases showed the reducing fracture healed osteally,and no prosthesis loosening. The followed-up period ranged 6 to 48 months,average 22 months. According to Harris stan-dard,the rate of excellent and good was 85.4%. Conclusion The effect of hip prosthetic replacement has the advan-tages of quick rehabilitation,bearing early full weight immediately and few complications after surgery. It is a proper treatment for senile patients with osteoporosis and unstable femoral intertrochanteric fracture.