人工股骨头置换治疗股骨粗隆间粉碎性骨折
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党晓谦 DANG Xiao-qian 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China dang_x iaoqian@sohu.com 
王坤正 WANG Kun-zheng 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China  
柏传毅 BAI Chuan-yi 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China  
时志斌 SHI Zhi-bin 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China  
宋金辉 SONG Jin-hui 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China  
王春生 WANG Chun-sheng 西安交通大学医学院第二附属医院骨科,陕西西安710004 Department of Orthopaedics,the Second Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710004,Shaanxi,China  
期刊信息:《中国骨伤》2007年,第20卷,第6期,第400-401页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:对高龄患者不稳定型股骨粗隆间骨折采用人工股骨头置换治疗效果进行回顾性分析。

方法:本组26例,男10例,女16例;年龄63~92岁,平均74岁。骨折按Evans分型:ⅢA型7例,ⅢB型16例,Ⅳ型3例。均为新鲜骨折。采用钢丝固定重建大粗隆,再扩髓并固定假体,或先固定假体,随后固定大粗隆骨折块。

结果:26例中12例发生低蛋白血症,8例低钾血症,17例有不同程度的患肢肿胀。20例随访1~2年,平均17个月,16例生活可自理,无假体下沉,行走无疼痛或轻微疼痛。1例人工股骨头反复脱位,但能手法复位。3例髋部疼痛较重需要口服止痛药物。髋关节功能按Harris标准评分:优13例,良3例,中4例。

结论:采用人工股骨头置换术治疗高龄患者非稳定性股骨粗隆间骨折,操作简单、创伤小,可明显改善患者的生活质量。
【关键词】股骨骨折  骨折,粉碎性  关节成形术,置换  股骨头
 
Artificial femoral head replacement for the treatment of comminuted intertrochanteric fracture in elderly patients
ABSTRACT  

Objective:To retrospectively study the therapeutic effects of artificial femoral head replacement for the treatment of elderly patients with unstable intertrochanter fracture.

Methods:Among 26 patients reviewed,10 patients were male and 16 patients were female,ranging in age from 63 to 92 years,with an average of 74 years.There were 7 type ⅢA,16 type ⅢB and 3 type Ⅳ fractures according to the Evans classification of intertrochanteric fracture.All patients were fresh fracture.The fragment of the greater trochanter was reconstructed with wire,then reaming and fixed the femur prosthesis.If the fracture of the greater trochanter was comminution,the femur prosthesis was fixed firstly,and then the greater trochanter was reconstructed.

Results:After treatment,hypoproteimenia occurred in 12 patients;kaliopenia occurred in 8 patients,extremity edema to different degree in 17 patients.Twenty patients were followed,ranged from 1 to 2 years,with an average of 17 months.Sixteen patients obtained self-care life without prosthesis subsidence,pain or slight pain when walking.One patient had prosthesis dislocation repeatedly,but it got reduction by using manipulative method.Three patients had severe hip pain and depended on analgetica.According to Harris score standard,the results were excellent in 13 patients,good in 3 patients,and poor in 4 patients.

Conclusion: Artificial femoral head replacement for the treatment of elderly patients with unstable intertrochanter fracture of femur has advantages of simple operation and little wound,which can improve life quantity.
KEY WORDS  Femoral fractures  Fractures,comminuted  Arthroplasty replacement  Femur head
 
引用本文,请按以下格式著录参考文献:
中文格式:党晓谦,王坤正,柏传毅,时志斌,宋金辉,王春生.人工股骨头置换治疗股骨粗隆间粉碎性骨折[J].中国骨伤,2007,20(6):400~401
英文格式:DANG Xiao-qian,WANG Kun-zheng,BAI Chuan-yi,SHI Zhi-bin,SONG Jin-hui,WANG Chun-sheng.Artificial femoral head replacement for the treatment of comminuted intertrochanteric fracture in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(6):400~401
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