股骨粗隆间骨折内固定失败后的假体置换治疗

[目的]探讨股骨粗隆间骨折内固定失败后采用假体置换术治疗的适应证、观察围手术期并发症、评价治疗效果。[方法]2002年1月～2004年12月收治粗隆间骨折内固定失败的患者中，8例采用股骨端特制的骨水泥型假体置换治疗。术后观察患者生活自理能力及手术并发症的发生情况。术后随访6—18个月，按照Harris标准评价手术治疗效果。[结果]手术均顺利完成，耗时约60～90min；无骨水泥方面的并发症；术后均顺利渡过围手术期，术前疼痛症状消失，无伤口感染、假体脱位、坠积性肺炎、褥疮、下肢深静脉栓塞等并发症；随访期问未出现假体松动、断裂方面的并发症。Harris评分：优5例，良2例，中1例。[结论]粗隆间骨折内固定失败后采用假体置换术治疗，术后可以获得较好的功能恢复和生活质量提高，手术并发症少，疗效较满意。

THR reoperation for intertrochanteric fracture after internal fixation failure

[Objective]To explore the indication of THR reoperation for intertrochanteric fracture after internal fixation failure,as well as the complications and it's effects.[Method]Among intertrochanteric fracture of internal fixation failure patients during January 2001 to December 2004,eight patients were treated with special femoral prosthesis THR.After operation they were followed up from 6 to 18 months and their self-care ability and complications with THR operation were observed.[Result]All operations were done successfully in 60 to 90 minutes without any bone cement complication.There were no infection,prosthesis dislocateion,hypostatic pneumonia,bed sore or deep veins thrombosis of lower limb compications and the pain in hip disappeared after operation,meanwhile neither loosening nor breaking of prosthesis was found during follow-up period.According to Harris score: 5 cases get excellent,2 cases get good and a case get general result.[Conclusion]THR for intertrochanteric fracture after internal fixation failure can get a good functional recovery and elevation of life quality with few complications to meet a satisfied outcome.