加长柄人工双动股骨头置换治疗高龄骨质疏松性股骨粗隆间骨折

目的 探讨加长柄人工双动股骨头置换治疗高龄骨质疏松性股骨粗隆间骨折的临床应用及意义。方法 2000年3月至2006年11月采用加长柄骨水泥型人工双动股骨头置换治疗高龄骨质疏松性股骨粗隆间不稳定性骨折28例，年龄75～99岁。取后外侧切口，术中力求大小粗隆骨块的复位，钢丝固定，确定前倾角及假体插入深度后，安放人工股骨头。结果 28例术后获7个月至3年随诊，平均1．5年，术后3个月按Harris评分标准进行功能评定，优8例，良13例，可5例，差2例。优良率达75％，未出现畸形病例，随诊期间未发现有关节脱位，有1例术后1年有假体下沉现象。差2例为术后内科病加重，影响功能恢复，1例术后1年后死于内科疾病。结论 加长柄人工双动股骨头置换治疗高龄骨质疏松性股骨粗隆间骨折，术后恢复快，能早期负重，减少并发症、死亡率，但要严格把握其适应证，以及掌握手术操作技巧。

Lengthen-stem bipolar-femur prosthetic replacement for the treatment of old patients with intertrochanteric fracture osteoporosis

Objective To evaluate the clinical application and significance of lengthen-stem bipolar-femur prosthetic replacement for the treatment of old-age patients with intertroehanteric fracture osteoporosis, Methods 28 cases of patients aging from 75 to 99 years old of intertroehanteric fracture osteoporosis treated with lengthenstem cemented bipolar prosthesis were studied from March 2000 to December 2006. After taking the blank margin, the bones of different sizes were replaced and the steel wire was fixed. After determining the depth of the front angle, the artificial bone was placed. Results After 28 examples attaining the following-up examination for 7 months to 3 years,with an average of 1.5 years,its function according to Harris standard was evaluated 3 months after the operation,8 examples were excellent, 13 examples good, 5 examples pass, 2 examples inferior. The excellent or good rate reached 75 %, with no abnormal cases, no joint dislocation during the followed-up period. 1 example had the phantom phenomenon I year after the operation. 2 examples anaong the inferior had got more serious internal medicine disease which affected the restoring function. 1 example died of the internal medicine disease 1 year after the operation. Conclusion By using the lengthen-stem bipolar-femur prosthetic replacement for the treatment of old patients with intertrochanteric fracture osteoporosis, the patients will restore quickly after the operation and can carry a heavy load at an early time. The illness complication and the mortality rate will be redaced. But its related disease must be strictly dealt with and the surgery operating skill must be grasped.