| 生物型加长柄半髋关节置换治疗高龄不稳定骨质疏松性股骨转子间骨折中期疗效随访 |
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Received:December 20, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 方剑利 |
FANG Jian-li |
浙江中医药大学附属宁波中医院 宁波市中医院骨伤科, 浙江 宁波 315016 |
Traditional Chinese Medical Hospital of Ningbo, Ningbo 315016, Zhejiang, China |
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| 林华杰 |
LIN Hua-jie |
浙江中医药大学附属宁波中医院 宁波市中医院骨伤科, 浙江 宁波 315016 |
Traditional Chinese Medical Hospital of Ningbo, Ningbo 315016, Zhejiang, China |
lwl6505@tom.com |
| 楼红侃 |
LOU Hong-kan |
浙江中医药大学附属宁波中医院 宁波市中医院骨伤科, 浙江 宁波 315016 |
Traditional Chinese Medical Hospital of Ningbo, Ningbo 315016, Zhejiang, China |
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| 金甬 |
JIN Yong |
浙江中医药大学附属宁波中医院 宁波市中医院骨伤科, 浙江 宁波 315016 |
Traditional Chinese Medical Hospital of Ningbo, Ningbo 315016, Zhejiang, China |
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| 期刊信息：《中国骨伤》2023年36卷，第7期，第658-661页 |
| DOI：10.12200/j.issn.1003-0034.2023.07.012 |
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目的：探讨生物型加长柄半髋关节置换治疗高龄不稳定骨质疏松性股骨转子间骨折中期疗效。
方法：自2016年1月至2019年1月治疗32例高龄不稳定骨质疏松性股骨转子间骨折患者，其中男12例，女20例；年龄85~95（89.5±4.5）岁。骨折分型按Evans分型：Ⅲ型12例，Ⅳ型11例，Ⅴ型9例。受伤至手术时间0.5~9（4.5±3.9） d。记录患者手术时间、总体失血量、术后并发症，术后疗效评价采用PPMS （Parker Palmer mobility score）及Harris髋关节功能评分标准。
结果：术后1年内死亡4例，死亡率为12.5%，其余28例患者均获得随访，时间24~60（28.5±4.5）个月，手术时间（54.2±22.5） min，总体失血量（显性出血+隐性失血）为（450±140） ml，无围手术期死亡，术后首次负重时间为（3.35±1.35） d；术后1、3、6个月及末次随访PPMS评分分别为（6.63±1.25）、（6.94±1.18）、（7.11±0.83）、（7.32±1.11）分，Harris评分分别为（67.85±6.19）、（71.42±5.57）、（73.41±5.62）、（77.32±5.24）分；术后1、3、6个月及末次随访PPMS及Harris评分比较差异无统计学意义（P>0.05）；末次随访时未见关节脱位、假体松动等并发症。
结论：在严格掌握病例选择标准前提下，采用生物型加长柄半髋关节置换治疗高龄不稳定骨质疏松性股骨转子间骨折中期疗效显著，可早期恢复髋关节功能，提高患者生存质量。 |
| [关键词]:关节成形术,置换,髋 股骨骨折 髋骨折 骨质疏松 |
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| A medium term analysis on of therapeutic effects of bio-lengthend stem hemiarthroplasty in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients |
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Abstract:
Objective To retrospectively study medium term follow up outcomes effects of effect of bio-lengthend stem hemiarthroplasty in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients.
Methods Total of 32 elderly patients with the osteoporotic intertrochanteric fractures were treated with bio-lengthend stem hemiarthroplasty from Jan. 2016 to Jan. 2019 including 14 males and 22 females, aged from 85 to 95 years old with an average of (89.5±4.5) years old. According to classification of Evans, there were 12 cases with type Ⅲ, 11 with type Ⅳ and 9 with type Ⅳ. The time from injury to operation ranged from 0.5 to 9 days with an average of (4.5±3.9) days. The operation time, blood loss and postoperative complications were analyzed. Functional outcome was assessed by Parker Palmer mobility score(PPMS) and Harris hip score.
Results Four patients died within one year after operation, and the mortality was 12.5%. The follow up time for the rest 28 patients ranged from 24 to 60 months with an average of (28.5±4.5) months. The mean operative time was (54.2±22.5) min;the mean blood loss (hidden blood loss+obvious blood loss) was (450±140) ml;the first weight bearing was (3.35±1.35) days. No perioperative death occurred. PPMS were(6.63±1.25), (6.94±1.18), (7.11±0.83), (7.32±1.11) and Harris scores were(67.85±6.19), (71.42±5.57), (73.41±5.62), (77.32±5.24) respectively at 1, 3, 6 months and the final follow-up after operation. There were no significant difference in PPMS and Harris score at 1, 3, 6 months after operation and the final follow-up(P>0.05). There were no complications such as joint dislocation and prosthesis loosening occure at the final follow-up.
Conclusion On the premise of strictly mastering the case selection criteria, the bio-lengthend stem hemiarthroplasty in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients has a satisfied medium term follow-up outcomes. It can restore hip function in the early stage and improve the quality of life of patients. |
| KEYWORDS:Arthroplasty,replacement,hip Femoral fractures Hip fractures Osteoporosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 方剑利,林华杰,楼红侃,金甬.生物型加长柄半髋关节置换治疗高龄不稳定骨质疏松性股骨转子间骨折中期疗效随访[J].中国骨伤,2023,36(7):658~661 |
| 英文格式: | FANG Jian-li,LIN Hua-jie,LOU Hong-kan,JIN Yong.A medium term analysis on of therapeutic effects of bio-lengthend stem hemiarthroplasty in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):658~661 |
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