| Wagner SL股骨柄治疗陈旧性或伴髋关节炎的股骨粗隆间骨折疗效观察 |
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Received:October 20, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈先武 |
CHEN Xian-wu |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
chenxianwu1982@163.com |
| 叶如卿 |
YE Ru-qing |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 许海平 |
XU Hai-ping |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年30卷，第3期，第264-269页 |
| DOI：10.3969/j.issn.1003-0034.2017.03.016 |
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目的：探讨Wagner SL 股骨柄治疗陈旧性或伴痛性髋关节炎的股骨粗隆间骨折的临床疗效。
方法：自2006年1月至2009年12月对8例陈旧性粗隆间骨折及21例伤前有痛性关节炎的粗隆间骨折使用Wagner SL股骨柄行全髋关节置换并重建粗隆，其中男18例，女11例；年龄43～58岁，平均49岁。术后临床随访，根据Harris 评分、肢体长度差异、髋关节活动范围以及髋外展肌力进行评价。影像学随访包括对股骨柄假体周围骨溶解、假体松动、透光线等进行评价。
结果：29例患者均成功完成手术，未出现与髋关节置换手术相关的严重并发症。术后均获得随访，时间6～10年，平均8.2年。均无不可接受的大腿疼痛主诉。8例陈旧性粗隆间骨折患者术后首次行走时均有“手术侧肢体过长”抱怨，随时间推移，这种抱怨在明显减少。术后3个月X线片提示21例伤前痛性关节炎的粗隆间骨折愈合，平均术后6个月（3～8个月）X线片提示8例陈旧性粗隆间骨折患者的植骨块与粗隆有明显骨痂连接，末次随访时X线片均未提示假体明显下沉。髋关节活动度基本恢复正常，无髋外展无力。根据Harris评分方法，手术后6年以上对患髋关节进行评价，优18例，良9例，可2例。
结论：Wagner SL 股骨柄在治疗陈旧性或伴痛性髋关节炎患者粗隆间骨折的初次全髋关节置换中可取得优良的临床疗效，粗隆重建，有利假体和关节稳定，同时增加骨储备。 |
| [关键词]:股骨粗隆间骨折 关节成形术，置换，髋 Wagner SL股骨柄 |
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| Clinical outcomes of total hip arthroplasty using Wagner SL revision stem in femoral intertrochanteric fractures for patients with old fracture or painful arthritis before injury |
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Abstract:
Objective: To retrospectively study the clinical results of total hip arthroplasty(THA)using Wagner SL revision stem for patients with femoral intertrochanteric fracture.
Methods: From 2006 January to 2009 December,29 consecutive patients with femoral intertrochanteric fractures were performed THA using Wagner SL revision stem and intertrochanteric reconstruction,including 18 males and 11 females with an average age of 49 years old ranging from 43 to 58. Among them,8 cases were oboslete femoral intertrochanteric fractures and 21 cases were the intertrochanteric fractures with painful arthritis before injuries. After the operation,the follow-up results were evaluated with clinical and radiographic criteria. The clinical follow-up results were evaluated by Harris score,limb length discrepancy,ROM of hips and the strength of the hip abductor. The X-ray imaging follow-up results were evaluated by periprosthetic osteolysis,prosthesis loosening and radiolucent.
Results: All the operations were successfully completed without serious complications associated with THA. Twenty-nine cases were followed up for a mean duration of 8.2 years(ranged,6 to 10). There was no acceptable thigh pain. The first time walk after operation,8 patients with oboslete intertrochanteric fracture complained the surgical sides were longer,with the passage of time,the complaint significantly reduced. At 3 months after operation,X-ray films of 21 cases showed intertrochanteric fractures healed well who had painful arthritis before injuries. An average of 6 months after operation(ranged,3 to 8),X-ray films of 8 cases of oboslete intertrochanteric fracture showed that the bone graft and trochanter with obvious callus connection. There were no obvious prosthesis subsidence on X-ray film at the final follow-up. The recovery of hip movement range was satisfactory,no hip abduction strength was weak. More than 6 years after the operation,according to the Harris scoring evaluation of hip joint,the result was excellent in 18 cases,good in 9 cases,general in 2 cases.
Conclusion: The clinical results of total hip arthroplasty using Wagner SL revision stem for patient with femoral intertrochanteric fracture is a reliable method,intertrochanteric reconstruction not only makes for prosthesis and joint stability,but also increases bone reserve. |
| KEYWORDS:Femoral intertrochanteric fractures Arthroplasty,replacement,hip Wagner SL revision stem |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈先武,叶如卿,许海平.Wagner SL股骨柄治疗陈旧性或伴髋关节炎的股骨粗隆间骨折疗效观察[J].中国骨伤,2017,30(3):264~269 |
| 英文格式: | CHEN Xian-wu,YE Ru-qing,XU Hai-ping.Clinical outcomes of total hip arthroplasty using Wagner SL revision stem in femoral intertrochanteric fractures for patients with old fracture or painful arthritis before injury[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):264~269 |
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