加长柄双极股骨头置换治疗高龄股骨转子间骨折

目的探讨加长柄双极人工股骨头置换治疗高龄股骨转子间骨折的疗效。方法本组49例,男19例,女30例;年龄75～92岁,平均82.3岁。骨折类型按Evans分型,型5例,A型22例,B型9例,型13例,其中2例为内固定治疗失败病例。患者多合并内科疾病,相关内科协同治疗后,对所有患者采用标准人工骨水泥、加长柄人工双极股骨头置换术,术后早期进行康复锻炼。结果 49例患者都顺利度过围手术期,住院期间无死亡病例,术后并发症均在住院期间治愈。术后1～3周下床活动。所有病例均获得随访,随访时间3～24个月,平均9个月,患者均能生活自理。按Harris评分标准,优良率达85.7%。结论用加长柄股骨头治疗高龄转子间骨折,是一种有效的治疗方法 ,可早期下床活动,减少并发症,提高生活质量。

Treatment of Femoral Intertrochanteric Fracture in Eldly Patients with Long-stem Bipolar Femoral Head Arthroplasty(A Report of 49 Cases)

Objective To investigate the clinical effect of treatment of femoral intertrochanteric fracture in the elderly patients with long-stem bipolar artificial femoral head arthroplasty.Methods There were 49 patients,aged between 75 and 92 years old（average 82.3 years old）.According to the fracture classification of Evans,there were 5 patients with typeⅡ,22 with type ⅢA,9 with type ⅢB and 13 with type Ⅳ fracture.The internal fixation failed in 2 patients.The long-stem cemented bipolar aitificial formal head arthroplasty was performed on all cases and patients with systemic diseases after treatment of internal medicine.The patients did earliest rehabilitation exercise after operation.Results All patients succeeded in operation.There was no death during the period of hospitalization and complication were cured.All patients got out of the bed after 1～3 weeks.49 patients were followed up 3 to 24 months（average 9 months）.They could take care of themselves.Eight five point seven percent patients achieved satisfactory results according to Harris rating scale.Coulusion It＇s an effective method to treat femoral interchanteric fractures in eldly patients with the long-stem bipolar femoral head prosthetic replacement.It has advantages such as earlier weight-bearing,less complication,and better life quality.