人工雙極股骨頭置換術治療老老年股骨頸骨折的療效分析_《華西醫學》

作者：

李雪寒 , 王恩才 , 張海濤

嘉應學院醫學院附屬醫院骨科（廣東梅州，514000）;

關鍵詞：

股骨頸骨折人工雙極股骨頭置換術老老年

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

【摘要】　目的　探討人工雙極股骨頭置換術治療老老年（ gt;80歲）股骨頸骨折的臨床療效。　方法　 2006年1月－2009年12月采用人工雙極股骨頭置換術治療23例老老年股骨頸骨折患者，其中男8例，女15例；年齡81~100歲，平均88歲。左側10例，右側13例。致傷原因：走路摔傷20例，交通事故傷3例。骨折按Garden分型：Ⅲ型14例，Ⅳ型9例。均為新鮮骨折，受傷至手術時間3~12 d。術前均合并慢性內科疾病。　結果　術后切口均I期愈合，3例發生肺部感染，1例發生深靜脈血栓形成，無切口感染及假體脫位。2例患者分別于術后5個月死于急性心肌梗死及術后1年死于高血壓性腦溢血。余21例均獲隨訪，隨訪時間12~48個月，平均26個月。X線片示假體位置良好。根據Harris髖關節評分標準：優12例，良6例，可2例，差1例，優良率為85.7%。　結論　人工雙極股骨頭置換術治療老老年股骨頸骨折手術時間短，可早期髖關節活動，減少了臥床并發癥，提高了生存率，改善了患者生活質量，是一種較理想的治療手段。
【Abstract】　Objective　 To discuss the clinical effects of bipolar hemiarthroplasty for treatment of femoral neck fracture in super-aged patients who were over 80 years old.　Methods　 From January 2006 to December 2009, 23 cases of femoral neck fracture were operated by bipolar hemiarthroplasty. Among the patients, there were 8 males and 15 females, with their age ranged from 81 to 100 years old averaging at 87.5 years. Ten patients had left femoral neck fracture, and 13 had right femoral neck fracture. Twenty patients had the injury because of falling on the ground while walking, and 3 due to car accident. Based on Garden classification, there were 14 cases of type Ⅲ and 9 of type Ⅳ fractures. All fractures were fresh. The interval between the injury and operation was 3 to 12 days. Before operation, all patients had concomitant chronic diseases.　Results　 All incisions healed in the first stage with 3 cases of lung infection and 1 case of deep venous thrombus, and without incision infection or prosthesis dislocation. One patient died of acute myocardial infarction 5 months after operation and the other one died of hypertensive cerebral hemorrhage 1 year after operation. All the remaining 21 patients were followed up for 12 to 48 months averaging at 26 months. X-ray result showed a good location of the prosthesis. According to the Harris scoring system, the results were very good in 12 cases, good in 6 cases, fair in 2 cases and poor in 1 cases, with a total effective rate of 85.7％.　Conclusions　 Bipolar hemiarthroplasty is an ideal method to treat femoral neck fracture in super-aged patients. It can shorten operation time, facilitate early movements of the hip joint, decrease complication rate due to lying in bed, and improve survival rate and quality of life.

引用本文： 李雪寒,王恩才,張海濤. 人工雙極股骨頭置換術治療老老年股骨頸骨折的療效分析. 華西醫學, 2011, 26(8): 1156-1158. doi: 復制

1.	盛璞義, 廖明威, 李佛保, 等. 假體置換治療老年股骨頸骨折的術前準備及術式選擇[J]. 中國矯形外科雜志, 1999, 6(6): 410-412.
2.	夏軍, 魏亦兵, 黃鋼勇, 等. 手術治療高齡髖部骨折的圍手術期并發癥[J]. 中華骨科雜志, 2005, 25(10): 591-592.
3.	Marya SK, Thukral R, Singh C. Prosthetic replacement in femoral neck fracture in the elderly:results and review of the literature[J]. Indian J Orthop, 2008, 42(1): 61-67.
4.	Ossendorf C, Scheyerer MJ, Wanner GA, et al. Treatment of femoral neck fractures in elderly patients over 60 years of age-which is the ideal modality of primary joint replacement?[J]. Patient Saf Surg, 2010, 4(1): 16.
5.	Macaulay W, Yoon RS, Parsley B, et al. Displaced femoral neck fractures:is there standard of care[J]. Orthopedics, 2007, 30(9): 748-749.
6.	Leighton RK, Schmidt AH, Collier P, et al. Advances in the treatment of intracapsular hip factures in the elderly[J]. J Injury, 2007, 38(3): 24-34.
7.	Tsukada S, Wakui M. Minimally invasive intermuscular approach does not improve outcomes in bipolar hemiarthroplasty for femoral neck fracture[J]. J Orthop Sci, 2010, 15(6): 753-757.
8.	Hedbeck CJ, Enocson A, Lapidus G, et al. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: A concise four-year follow-up of a randomized trial[J]. J Bone Joint Surg(Am), 2011, 93(5): 445-450.
9.	許軍, 趙玉馳, 黃仁輝, 等. 骨水泥型雙極人工股骨頭置換治療高齡股骨頸骨折[J]. 臨床骨科雜志, 2010, 13(1): 43-44.
10.	Jeffcote B, Li MG, Barnet-Moorcroft A, et al. Roentgen stereophotogrammetric analysis and clinical assessment of unipolar versus bipolar hemiarthroplasty for subcapital femur fracture: a randomized prospective study[J]. ANZ J Surg, 2010, 80(4): 242-246.

1. 　盛璞義, 廖明威, 李佛保, 等. 假體置換治療老年股骨頸骨折的術前準備及術式選擇[J]. 中國矯形外科雜志, 1999, 6(6): 410-412.
2. 　夏軍, 魏亦兵, 黃鋼勇, 等. 手術治療高齡髖部骨折的圍手術期并發癥[J]. 中華骨科雜志, 2005, 25(10): 591-592.
3. 　Marya SK, Thukral R, Singh C. Prosthetic replacement in femoral neck fracture in the elderly:results and review of the literature[J]. Indian J Orthop, 2008, 42(1): 61-67.
4. 　Ossendorf C, Scheyerer MJ, Wanner GA, et al. Treatment of femoral neck fractures in elderly patients over 60 years of age-which is the ideal modality of primary joint replacement?[J]. Patient Saf Surg, 2010, 4(1): 16.
5. 　Macaulay W, Yoon RS, Parsley B, et al. Displaced femoral neck fractures:is there standard of care[J]. Orthopedics, 2007, 30(9): 748-749.
6. 　Leighton RK, Schmidt AH, Collier P, et al. Advances in the treatment of intracapsular hip factures in the elderly[J]. J Injury, 2007, 38(3): 24-34.
7. 　Tsukada S, Wakui M. Minimally invasive intermuscular approach does not improve outcomes in bipolar hemiarthroplasty for femoral neck fracture[J]. J Orthop Sci, 2010, 15(6): 753-757.
8. 　Hedbeck CJ, Enocson A, Lapidus G, et al. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: A concise four-year follow-up of a randomized trial[J]. J Bone Joint Surg(Am), 2011, 93(5): 445-450.
9. 　許軍, 趙玉馳, 黃仁輝, 等. 骨水泥型雙極人工股骨頭置換治療高齡股骨頸骨折[J]. 臨床骨科雜志, 2010, 13(1): 43-44.
10. 　Jeffcote B, Li MG, Barnet-Moorcroft A, et al. Roentgen stereophotogrammetric analysis and clinical assessment of unipolar versus bipolar hemiarthroplasty for subcapital femur fracture: a randomized prospective study[J]. ANZ J Surg, 2010, 80(4): 242-246.

《華西醫學》

人工雙極股骨頭置換術治療老老年股骨頸骨折的療效分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《華西醫學》

人工雙極股骨頭置換術治療老老年股骨頸骨折的療效分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料