| 人工股骨双动头置换治疗高龄不稳定型股骨转子间骨折的并发症分析 |
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投稿时间：2010-03-03
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| 作者 | Author | 单位 | Address | E-Mail |
| 包倪荣 |
BAO Ni-rong |
第二军医大学南京临床医学院骨科 南京军区南京总医院骨科,江苏 南京 210002 |
Department of Orthopaedics,Nanjing Clinical School,the Second Military Medical University,Nanjing 210002,Jiangsu,China |
zhenpingok@163.com |
| 赵建宁 |
ZHAO Jian-ning |
第二军医大学南京临床医学院骨科 南京军区南京总医院骨科,江苏 南京 210002 |
Department of Orthopaedics,Nanjing Clinical School,the Second Military Medical University,Nanjing 210002,Jiangsu,China |
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| 周利武 |
ZHOU Li-wu |
第二军医大学南京临床医学院骨科 南京军区南京总医院骨科,江苏 南京 210002 |
Department of Orthopaedics,Nanjing Clinical School,the Second Military Medical University,Nanjing 210002,Jiangsu,China |
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| 曾晓峰 |
ZENG Xiao-feng |
第二军医大学南京临床医学院骨科 南京军区南京总医院骨科,江苏 南京 210002 |
Department of Orthopaedics,Nanjing Clinical School,the Second Military Medical University,Nanjing 210002,Jiangsu,China |
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| 郭亭 |
GUO Ting |
第二军医大学南京临床医学院骨科 南京军区南京总医院骨科,江苏 南京 210002 |
Department of Orthopaedics,Nanjing Clinical School,the Second Military Medical University,Nanjing 210002,Jiangsu,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第5期，第329-331页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.002 |
| 基金项目: |
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中文摘要:
目的：分析人工股骨双动头置换治疗股骨转子间骨折的并发症及其原因。
方法：2004年1月至2007年12月62例高龄不稳定型股骨转子间骨折采用人工股骨双动头置换，其中男34例，女28例；年龄81～97岁，平均86.3岁。按Evans分型法：Ⅲ型29例，Ⅳ型26例，Ⅴ型7例。研究分析系统和局部并发症的发生情况。
结果：59例出院后通过门诊获得随访，时间24～70个月，平均33个月。围手术期发生全身系统并发症19例，在院期间无死亡，院外死亡5例。手术局部相关并发症9例，包括大腿痛3例，医源性骨折1例，骨折延迟愈合2例，髋关节脱位2例，伤口浅表感染1例，无假体松动、假体周围感染、异位骨化或神经血管损伤。
结论：人工股骨双动头置换术治疗股骨转子间骨折适于80岁以上患者，因此在围手术期应尽可能纠正全身各器官及系统功能异常，保留小转子并重建股骨距对改善假体周围生物力学及减少局部并发症具有重要意义。 |
| 【关键词】股骨 髋骨折 关节成形术,置换,髋 手术后并发症 |
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| Complications of bipolar hemiarthroplasty for the treatment of unstable intertrochanteric fractures in the elderly |
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ABSTRACT
Objective: To analyze the complications of bipolar hemiarthroplasty for the treatment of intertrochanteric fractures.
Methods: From Jan. 2004 to Dec.2007,62 patients over 80 years old with unstable interthochanteric fracture were treated with bipolar hemiarthroplasty,included 34 males and 28 females with an average age of 86.3 years ranging from 81 to 97 years. According to the Evans classification,there were 29 cases of Evans Ⅲ，26 of Evans Ⅳ and 7 of Evans Ⅴ。 The systemic and operation related complications were investigated.
Results: Among all the cases,59 were followed up in outpatient department for 24 to 70 months(33 months on average). Systemic complications were found in 19 cases with no death during preoperative period and 5 deaths after leaving hospital. Operation related complications were found in 9 cases,included 3 cases of thigh pain,1 iatrogenic fracture of proximal femur,2 hip dislocations,2 delayed union of fractures and 1 superficial infection. There were no aseptic loosening,peri-prosthetic infections,ectopic ossification or injuries of nerves and vessels.
Conclusion: Bipolar hemiarthroplasty is indicated for patients over 80 years old with intertrochanteric fracture,thus the organic or systemic malfunctions should be corrected during perioperative period. Meanwhile,retaining of lesser trochanter and reconstruction of calcar femorale are important for improving periprosthetic biomechanics and reducing local complications. |
| KEY WORDS Femur Hip fractures Arthroplasty,replacement,hip Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 包倪荣,赵建宁,周利武,曾晓峰,郭亭.人工股骨双动头置换治疗高龄不稳定型股骨转子间骨折的并发症分析[J].中国骨伤,2010,23(5):329~331 |
| 英文格式: | BAO Ni-rong,ZHAO Jian-ning,ZHOU Li-wu,ZENG Xiao-feng,GUO Ting.Complications of bipolar hemiarthroplasty for the treatment of unstable intertrochanteric fractures in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):329~331 |
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