| 全髋关节置换术治疗股骨转子间不稳定性骨折合并股骨头坏死7年随访 |
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投稿时间：2021-07-21
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| 作者 | Author | 单位 | Address | E-Mail |
| 张占丰 |
ZHANG Zhan-feng |
湖州市第一人民医院, 浙江 湖州 313000 |
The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China |
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| 闵继康 |
MIN Ji-kang |
湖州市第一人民医院, 浙江 湖州 313000 |
The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China |
2504074093@qq.com |
| 杨红航 |
YANG Hong-hang |
湖州市第一人民医院, 浙江 湖州 313000 |
The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China |
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| 钟建明 |
ZHONG Jian-ming |
湖州市第一人民医院, 浙江 湖州 313000 |
The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第7期，第630-633页 |
| DOI：10.12200/j.issn.1003-0034.2022.07.007 |
| 基金项目:湖州市科技局公益性应用研究项目（编号：2020GYB26） |
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中文摘要:
目的:探讨全髋关节置换术治疗合并股骨头坏死的股骨转子间不稳定性骨折的效果和中长期随访情况。
方法：自2008年3月至2014年10月采用全髋关节置换术对股骨转子间不稳定性骨折合并股骨头坏死的患者23例进行治疗，男10例，女13例；年龄59~82（68.4±10.4）岁。根据Evans-Jensen分型，Ⅱa型8例，Ⅱb型6例，Ⅲ型9例。根据Ficat分期，Ⅱa期3例，Ⅱb期3例，Ⅲ期9例，Ⅳ期8例。术后观察并发症发生情况，以Harris评分进行髋关节功能评价，术后7年时评估假体生存率。
结果：术后出现并发症2例，1例患者术后3个月时出现急性假体周围感染，1例患者术后3个月时出现髋关节脱位。23例患者均获得随访，随访时间61~110（85.1±22.9）个月。末次随访时Harris评分83~92（89.8±5.2）分，与术前比较差异有统计学意义（P<0.05）。影像学显示所有患者转子间骨折获得骨性愈合。23例患者假体7年生存率为95.7%。
结论：对于合并股骨头坏死的股骨转子间不稳定性骨折使用人工全髋关节置换术治疗，可以同时治疗骨折和术前症状性髋关节疼痛，具有满意的中长期效果。 |
| 【关键词】关节成形术,置换,髋 髋骨折 股骨头坏死 |
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| Total hip arthroplasty for unstable intertrochanteric fractures with necrosis of the femoral head: a 7-year follow-up |
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ABSTRACT
Objective: To discuss the result and long time follow-up of unstable intertrochanteric fracture combined with avascular necrosis of femoral head treated by total hip arthroplasty.
Methods: From March 2008 to October 2014, 23 cases were enrolled and treated by total hip arthroplasty, including 10 males and 13 females, aged 59 to 82 years old with an average of(68.4±10.4) years old. There were 8 cases of type Ⅱa fractures, 6 cases of type Ⅱb fractures, 9 cases of type Ⅲ fractures according to Evans Classification. There were 3 cases of type Ⅱa, 3 cases of type Ⅱb, 9 cases of type Ⅲ, 8 cases type Ⅳaccording to Ficat Classification. The complications were recorded, the joint function was evaluated by Harris score and prosthesis survival rate was analysed.
Results: Postoperative complications occurred in 2 cases, one patient had acute periprosthetic infection 3 months after operation, and one patient had hip dislocation 3 months after operation. All 23 patients were followed up for 61 to 110 months with an agerage of (85.1±22.9) months. The Harris score at the final follow-up was 83 to 92 months with an average of(89.8±5.2) months, which was significantly different from that before operation (P<0.05). Imaging showed that all patients had bone healing of intertrochanteric fractures. The 7-year survival rate of prosthesis in 23 patients was 95.7%.
Conclusion: The symptoms of unstable intertrochanteric fracture combined with avascular necrosis of femoral head could be solved by total hip arthroplasty, and the long time result was satisfied. |
| KEY WORDS Arthroplasty, replacement, hip Hip fractures Femur head necrosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张占丰,闵继康,杨红航,钟建明.全髋关节置换术治疗股骨转子间不稳定性骨折合并股骨头坏死7年随访[J].中国骨伤,2022,35(7):630~633 |
| 英文格式: | ZHANG Zhan-feng,MIN Ji-kang,YANG Hong-hang,ZHONG Jian-ming.Total hip arthroplasty for unstable intertrochanteric fractures with necrosis of the femoral head: a 7-year follow-up[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(7):630~633 |
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