长柄人工髋关节置换治疗高龄股骨转子间骨折的实验及临床研究

目的 进行人股骨转子间骨折特制长柄股骨头置换的生物力学实验,在此基础上应用于临床并观察其临床疗效及并发症的发生。方法 设计长柄人工股骨头,模拟人股骨转子间粉碎性骨折进行置换,做为实验组,同时设对照组及标准组进行生物力学测定,在此基础上采用该方法治疗70岁以上粉碎性股骨转子间骨折29例,对住院时间、术后负重行走时间、并发症及术后病死率进行观察、随访。结果 人股骨转子间骨折特制长柄股骨头置换的生物力学测定符合生物力学要求。临床应用,平均住院时间为15 d,平均术后负重行走时间为12.4 d,术后并发髋关节疼痛2例,术后3个月死亡1例。结论 长柄人工股骨头置换治疗老年病人粉碎性粗隆间骨折,功能恢复好、能早期负重下地、并发症少,临床上值得推广使用。

An Experimental and Clinical Study on Long-stem Prosthetic Replacement of Comminuted Intertrochanteric Fracture of Femur in the Elderly Osteoporotic Patients

Objective To observe the curative effect of long-stem prosthetic replacement of comminuted intertrochanteric fracture of femur in the elderly, osteoporotic patients. Methods Twenty nine consecutive patients who were more than 70 years old and had an unstable intertrochanteric fracture were treated with long-stem prosthetic replacement from 1998 through 2000. The average hospital stay, the average time to ambulation with full-weight bearing on the operated limb after the operation, complication and mortality rates were observed. Results The average hospital stay of the patients was 15 days, the average time to ambulation was 12.4 days, the incidence rate of the pain of the hip joint was 10 percent, the mortality rate of the patients was 5 percent at 3 months after the operation. Conclusion Long-stem prosthetic replacement for unstable intertrochanteric fractures in the elderly, osteoporotic patients may be a suitable alternative to internal fixation because the prosthesis provides for early full weight-bearing and rapid rehabilitation.