人工关节置换术治疗老年股骨颈骨折81例临床观察

目的探讨人工关节置换术治疗老年股骨颈骨折的临床效果。方法选取2005-08～2011-08老年股骨颈骨折患者81例(其中头下型28例,经颈型26例,头颈型17例,基底型10例),均采用人工关节置换术治疗。结果 1例术前合并有高血压和糖尿病患者,术后24 h脑卒中死亡。1例脱位属DorrⅠ类,经徒手复位成功,继用皮牵引治愈。其余79例术后1周左右可扶拐下地部分负重行走,1个月后可逐步弃拐行走,2个月后髋关节功能活动基本正常。80例患者伤口一期愈合。按sanders评分标准优46例(56.8%),良25例(30.9%),可9例(11.1%),差1例(1.2%),平均得分为50分。结论人工关节置换术治疗老年股骨颈骨折优良率高,且手术时间短,术中出血少,住院时间及卧床时间短,再手术率低,是临床上治疗老年股骨颈骨折的一种有效方法。

Clinical observation of artificial joint raplacement in the treatment of 81 elderly patients with femoral neck fracture

Objective To investigate the clinical effect of artificial joint replacement in the treatment of 81 elderly patients with femoral neck fracture.Methods Eighty -one elderly patients with femaral neck fracure in our hostital from August 2005 to August 2011 were treated by artifical joint replacement,including sub-head type frature (28 cases),via neck type fracure 26 cases,head-neck type fracure(17cases),basal-neck type fracure(10 cases ). Results One patient,who suffered from hypertension and diabetes before operation,died of of stroke 24 h after operation.One patient with dislocation of Dorr I class was cured by manual reduction and the use of skin traction. About 1 week after operation,the remaining patients can resume partial weight-bearing walking ability,1 month after operation patiants can gradually,walk without crutcines,two months after operation the functional activities of normal hip joint were recovered in all patients.The primary wound healing was obtained in 80 patients.By sanders scoring the excellent effect(55 to 60 scores) was obtained in 46 patients,accounted for 56.8%;good(45 ~ 54 scores) in 25 patients,accounted for 30.9%;fair(35-44 scores) in 9 patients,accounted for 11.1%;poor in 1 patient,1.2%.The average score was 50 scores.Conclusion Artificial joint replacement in the treatment of elderly palials with femoral neck fracture has a fine care rate.It has advantates of shorter operative time,less blood loss, sharter hospital stay and bed time,lower re-operation rate,and is an effective method for treatment of elderly patients with femoral neck fracture.