双极人工股骨头置换治疗高龄股骨颈骨折的疗效分析

目的探讨高龄股骨颈骨折应用双极人工股骨头置换的临床疗效。方法对63例高龄股骨颈骨折患者行骨水泥固定的国产双极人工股骨头置换,术后根据Harris评分法和X线资料评定其疗效。结果本组63例均成功完成手术,术中无血管神经损伤。术后无切口感染和关节脱位,无围术期死亡。术后随访10～42(15.3±2.1)个月。术后合并肺部感染6例,泌尿系感染5例,下肢深静脉血栓形成3例,中枢神经系统功能障碍2例,脑梗死1例。X线片检查显示髋关节间隙变窄11例,假体轻度内翻5例,出现假体下沉3例,骨水泥周围<2 mm的透亮带2例。根据Harris评分法评定,优22例,良26例,中12例,差3例,优良率76.19%。结论应用骨水泥固定的双极股骨头置换治疗高龄股骨颈骨折疗效满意。

Treatment of elder femoral neck fracture with bipolar artificial femoral head arthroplasty

Objective To explore the effects of bipolar artificial femoral head arthroplasty in treatment of elder femoral neck fracture.Methods Sixty-three elderly patients with femoral neck fracture were treated with domestic bipolar artificial femoral head arthroplasty.Harris hip score system and X-ray were used to evaluate the outcomes.Results All the 63 patients were performed the operation successfully and survived.Neither vessel and nerve injury nor infection and dislocation happened.None died during the operation.They were followed up from 10 to 42 months with an average of(15.3 ± 2.1) months.Some suffered from post-operative complications including pneumonitis in 6,urinary infection in 5,deep venous thrombosis in 3,dysfunction in central nerve system in 2 and cerebral infarction 1 case(s).Based on X-rays outcomes,there were 11 cases suffered from narrow joint space,5 cases from mild prosthesis protrusion,3 cases from prosthesis subsidence,and 2 cases from lucent line(within 2mm).According to Harris score system,the outcomes were excellent in 22,good in 26,ordinary in 12,and poor in 3 cases.The rate of both excellent and goof was 76.19%.Conclusion Bipolar artificial femoral head arthroplasty is a reasonable choice for treatment of femoral neck fracture in the elderly.