人工股骨头置换治疗高龄股骨转子间骨折的早期康复

目的探讨高龄股骨转子间骨折的早期康复方法、适应证和疗效。方法对近十年经治的62例转子间骨折中,采用人工股骨头置换的高龄(平均84岁)患者19例,取小切口、双动人工股骨头骨水泥固定9例,传统大切口10例。随访1~9年半,平均4年11个月,与同期37例转子间骨折行多种内固定术的围手术期指标进行比较。结果19例中,患髋功能良好,1例于1年后因肺心病死亡,2例假体下沉,有轻中度髋痛。Harris评分:优(90~100)8例,良(80~89)5例,可(70~79)3例,差(<70)2例。结论高龄股骨转子间骨折采用人工股骨头置换能更早下床和具有早期康复的独特优势。

The Treatment of Femoral Intertrochanteric Fractures With Hemi-hip Prosthesis Replacement for senile Patients

Objective To study the indications,methods and results of treatment the femoral intertrochanteric fractures using hemi-hip prosthesis replacement in senile patients.Methods From 1994 to June 2004,nineteen patients with femoral intertrochanteric fractures over 80 years old undenwent cement hemi-hip prosthesis replacement.The mean age was 84(ranging from 81 to 93).Mini-incise were done in nine cases,and conventional incise and bipolar hemi-hip prosthesis were done in ten.The mean follow-up was four years and eleven months(range from 1 to 9.5 years).The results were compared with femoral intertrochanteric fractures treatment of thirty-seven cases using the internal fixator during the same time for the condition of around operation.Results One case died with pulmonary-heart disease at one year after the operation and two cases' prosthetic sink with mild or moderate hip pain.The others could walk without hip pain and have no radiographic evidence of acetabular wear as well as prosthesis dislocation during the follow-up.The Harris evaluation were finished,excellence(90~100) in eight cases,good(80~89)in five,fair(70~79)in three,and poor(< 70) in two.Conclusion The hemi-hip prosthetic replacement can treat femoral intertrochanteric fractures for the senile patients while cases was correct selected.