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Ⅰ期全髋置换治疗严重髋关节骨性关节炎伴股骨近端骨折
Hits: 1846   Download times: 1116   Received:January 20, 2019    
作者Author单位UnitE-Mail
李金堂 LI Jin-tang 吉林大学第一医院骨关节外科, 吉林 长春 130021 Department of Joint Orthopaedics, No.1 Hospital of Jilin University, Changchun 130021, Jilin, China  
李叔强 LI Shu-qiang 吉林大学第一医院骨关节外科, 吉林 长春 130021 Department of Joint Orthopaedics, No.1 Hospital of Jilin University, Changchun 130021, Jilin, China 1656221657@qq.com 
王兴 WANG Xing 伊通满族自治县第一人民医院, 吉林 四平 130700  
李健 LI Jian 通榆县医院, 吉林 白城 137200  
高航 GAO Hang 吉林大学第一医院骨关节外科, 吉林 长春 130021 Department of Joint Orthopaedics, No.1 Hospital of Jilin University, Changchun 130021, Jilin, China  
李冬松 LI Dong-song 吉林大学第一医院骨关节外科, 吉林 长春 130021 Department of Joint Orthopaedics, No.1 Hospital of Jilin University, Changchun 130021, Jilin, China  
期刊信息:《中国骨伤》2019年32卷,第5期,第412-417页
DOI:10.3969/j.issn.1003-0034.2019.05.005


目的:探讨Ⅰ期全髋置换治疗严重髋关节骨性关节炎伴股骨近端骨折的疗效及预后。

方法:2014年7月至2017年10月,采用Ⅰ期全髋置换治疗8例严重的终末期髋关节疾病伴股骨近端骨折患者,男6例,女2例;年龄59~72岁,平均65岁;右侧股骨头坏死伴右侧股骨近端骨折4例,左侧股骨头坏死伴左侧股骨近端骨折3例,左侧髋臼发育不良伴左侧股骨近端骨折1例。患者受伤至手术时间平均7 d。8例患者均采用生物型加长柄人工髋关节假体。

结果:8例Ⅰ期全髋置换患者术后均获得随访,随访时间12~48个月,平均31个月。随访期间假体无松动、下沉,Harris评分从术前平均33分(22~42分)提高到末次随访时平均87分(82~90分),其中优3例,良5例。术后3个月弃拐行走,术后3~6个月X线片显示骨折愈合良好,患者髋关节疼痛和功能明显改善,生活质量得到极大提高。

结论:严重的髋关节骨性关节炎伴股骨近端骨折患者采取Ⅰ期全髋关节置换具有缩短治疗时间、减轻患者痛苦、减少住院费用、预后效果好等优点。
[关键词]:骨关节炎,髋  股骨近端骨折  关节成形术,置换,髋
 
PhaseⅠtotal hip replacement for severe hip osteoarthritis with proximal femoral fractures
Abstract:

Objective:To investigate the effect and prognosis of stageⅠtotal hip replacement in the treatment of severe hip osteoarthritis with proximal femoral fracture.

Methods:From July 2014 to October 2017,8 patients with severe end-stage hip disease and proximal femoral fracture were treated with stageⅠtotal hip replacement including 6 males and 2 females,aged 59 to 72 years old with an average age of 65 years old,involving 4 femoral head necrosis with proximal femoral fracture in the right side,3 femoral head necrosis with proximal femoral fracture in the left side,and 1 left acetabular dysplasia with proximal femoral fracture in the left side. The average time from injury to operation was 7 days. Eight patients were treated with biologically elongated hip prosthesis.

Results:Eight patients with stageⅠtotal hip arthroplasty were followed up for 12 to 48 months with an average of 31 months. During the follow-up period,there was no loosening or subsidence of the prosthesis. Harris score increased from 33 points (22 to 42 points) preoperatively to 87 points(82 to 90 points) at the last follow-up. Among them,3 cases were excellent and 5 cases were good. Abandoned abduction and walked 3 months after operation. X-ray films during 3-6 months after operation showed that fracture healing was good,hip pain and function were improved significantly,and the quality of life was greatly improved.

Conclusion:PhaseⅠtotal hip arthroplasty for severe hip osteoarthritis patients with proximal femoral fracture has the advantages of shortening the treatment time,alleviating patients'pain,reducing hospitalization costs and good prognosis.
KEYWORDS:Osteoarthritis,hip  Proximal femoral fracture  Arthroplasty,replacement,hip
 
引用本文,请按以下格式著录参考文献:
中文格式:李金堂,李叔强,王兴,李健,高航,李冬松.Ⅰ期全髋置换治疗严重髋关节骨性关节炎伴股骨近端骨折[J].中国骨伤,2019,32(5):412~417
英文格式:LI Jin-tang,LI Shu-qiang,WANG Xing,LI Jian,GAO Hang,LI Dong-song.PhaseⅠtotal hip replacement for severe hip osteoarthritis with proximal femoral fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(5):412~417
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