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人工关节置换治疗股骨颈骨折内固定失败的疗效观察
Hits: 2081   Download times: 1136   Received:January 05, 2015    
作者Author单位UnitE-Mail
吕波 LYU Bo 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China  
王跃 WANG Yue 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China  
朱建辛 ZHU Jian-xin 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China  
黄崇新 HUANG Chong-xin 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China  
杨晓 YANG Xiao 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China 544061822@qq.com 
廖天成 LIAO Tian-cheng 四川省医学科学院 四川省人民医院骨科, 四川 成都 610072 Department of Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China  
期刊信息:《中国骨伤》2015年28卷,第9期,第784-787页
DOI:10.3969/j.issn.1003-0034.2015.09.002


目的:观察人工髋关节置换治疗股骨颈骨折内固定失败患者的临床疗效.

方法:自2007年6月至2014年1月采用人工髋关节置换治疗29例股骨颈骨折内固定失败的患者,其中男12例,女17例;年龄43~83岁,平均60.3岁;左髋16例,右髋13例.内固定距关节置换时间3~48个月,平均23.3个月.

结果:29例患者中,直接生物杯固定20例,植骨修复缺损后生物杯固定7例,植骨修复缺损钛网杯固定后骨水泥臼杯固定2例;股骨柄生物型柄13例,骨水泥柄16例.无术中并发症发生,手术时间(115±38) min,术中出血量(420±175) ml,术后引流量(240±119) ml,术中输血量(200±220) ml,术中补液量(2 200±400) ml,术后输血量(300±200)ml,术后早期脱位1例.术后随访时间5~24个月,平均14.7个月,均愈合良好,未发生假体下沉、松动、脱位等现象.Harris评分由术前的51.1±7.5提高到末次随访88.5±6.4.

结论:人工关节置换治疗股骨颈骨折内固定失败患者,可早期下地功能锻炼,减少卧床时间及并发症的发生,有利于早期功能恢复,远期疗效需要进一步观察.
[关键词]:关节成形术,置换,髋  股骨颈骨折  骨折固定术,内  外科手术
 
Hip arthroplasty for failed internal fixation of femoral neck fractures
Abstract:

Objective: To investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

Methods: From June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

Results: All of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup, 7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115±38) minutes, the mean intraoperative blood loss was (420±175) ml, the average postoperative drainage volume (240±119) ml, intraoperative blood transfusion was (200±220) ml, intraoperative fluid volume was (2 200±400) ml, the average postoperative blood transfusion was (300±200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1±7.5 before the conversion to 88.5±6.4 points at the final follow-up.

Conclusion: The effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.
KEYWORDS:Arthroplasty, replacement, hip  Femoral neck fractures  Fracture fixation, internal  Surgical procedures, operative
 
引用本文,请按以下格式著录参考文献:
中文格式:吕波,王跃,朱建辛,黄崇新,杨晓,廖天成.人工关节置换治疗股骨颈骨折内固定失败的疗效观察[J].中国骨伤,2015,28(9):784~787
英文格式:LYU Bo,WANG Yue,ZHU Jian-xin,HUANG Chong-xin,YANG Xiao,LIAO Tian-cheng.Hip arthroplasty for failed internal fixation of femoral neck fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(9):784~787
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