赖玉珠;吕辉照;赵枫;曹杰;张爱玲;

• 1:解放军第180医院骨二科

摘要(Abstract)：

[目的]探讨骨水泥强化Y-STRUT内固定系统治疗骨质疏松性股骨颈隐匿性骨折的近期疗效。[方法]2015年1月~2017年2月,本院骨科共收治骨质疏松性股骨颈隐匿性骨折15例,均接受股骨颈Y-STRUT骨水泥强化内固定治疗。其中男4例,女11例;年龄59~80岁,平均(71.42±7.04)岁。骨密度T值-2.5SD~-3.3SD,平均(-3.06±0.20)SD。所有患者标准骨盆正位X线片均为阴性,均通过CT或MRI确诊。按Garden分型,骨折均为I型。记录评估手术时间、出血量、骨水泥注射量、住院时间、VAS评分与髋关节Harris功能评分。[结果]所有患者均顺利手术,手术时间35~65 min,平均(48.00±14.82)min;出血量10~30 ml,平均(16.22±4.40)ml。骨水泥注射量6~15 ml,平均(9.23±2.01)ml。住院时间:3~11 d,平均(5.38±1.18)d。所有患者均获得随访12~23个月,平均(14.20±1.80)个月。术后各时间点负重时的VAS评分均较术前显著减少,差异有统计学意义(P<0.05);但术后各时间点间VAS评分比较,差异无统计学意义(P>0.05)。各时间点髋关节Harris功能评分比较,差异无统计学意义(P>0.05)。[结论]对于骨质疏松性股骨颈隐匿性骨折,Y-STRUT骨水泥强化内固定系统具有快速止痛和早期负重的优点,是一种安全、操作简单的治疗手段。

关键词(KeyWords)： 骨质疏松症;股骨颈骨折;隐匿性骨折;骨水泥强化

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 赖玉珠;吕辉照;赵枫;曹杰;张爱玲;

Email:

DOI:

参考文献(References)：

• [1]Deleanu B,Prejbeanu R,Tsiridis E,et al.Occult fractures of the proximal femur:imaging diagnosis and management of 82 cases in a regional trauma center[J].World J Emaerg Surg,2015,10:55.
• [2]Bawa HS,Weick J,Dirschl DR.Anti-osteoporotic therapy after fragility fracture lowers rate of subsequent fracture:analysis of a large population sample[J].J Bone Joint Surg Am,2015,97(19):1555-1562.
• [3]Leblanc KE,Muncie HL,Leblanc LL.Hip fracture:diagnosis,treatment,and secondary prevention[J].Am Fam Physician,2014,89(12):945-951.
• [4]Cornelis FH,Tselikas L,Carteret T,et al.Percutaneous internal fixation with Y-STRUT device to prevent both osteoporotic and pathological hip fracture:a prospective pilot study[J].J Orthop Surg Res,2017,12(1):27-32.
• [5]Dunker D,Collin D,Gothlin JH,et al.High clinic alutility of computed tomography compared to radiography in elderly patients with occult hip fracture after low-energy trauma[J].Emerg Radiol,2012,19(2):135-139.
• [6]Heikal S,Riou P,Jones L.The use of computed tomography in identifying radiologically occult hip fractures in the elderly[J].Ann R Coll Surg Engl,2014,96(3):234-237.
• [7]Siu AL,Penrod JD,Boockvar KS,et al.Early ambulation after hip fracture:effects on function and mortality[J].Arch Intern Med,2006,166(7):766-771.
• [8]Rubin G,Malka I,Rozen N.Should we operate on occult hip fractures[J].Isr Med Assoc J,2010,12(5):316-317.
• [9]Deschamps F,De Baere T,Hakime A,et al.Percutaneous osteosynthesis in the pelvis in cancer patients[J].Eur Radiol,2016,26(6):1631-1639.
• [10]Ristevski B,Jenkinson RJ,Stephen DJ,et al.Mortality and complications following stabilization of femoral metastatic lesions:a population-based study of regional variation and outcome[J].Can J Surg,3009,52(4):302-308.
• [11]Szpalski M,Gunzburg R,Aebi M,et al.A new approach to prevent contralateral hip fracture:Evaluation of the effectiveness of a fracture preventing implant[J].Clin Biomech,2015,30(7):713-719.
• [12]Tian QH,He CJ,Wu CG,et al.Comparison of percutaneous cementoplasty with and without interventional internal fixation for impending malignant pathological fracture of the proximal femur[J].Cardiovasc Intervent Radiol,2015,39(1):81-89.
• [13]Parker MJ,Khan AZ,Rowlands TK.Survival after pathological fractures of the proximal femur[J].Hip Int,2011,21(5):526-530.
• [14]Heini PF,Franz T,Fankhauser C,et al.Femoroplasty augmentation of mechanical properties in the osteoporotic proximal femur:a biomechanical investigation of PMMA reinforcement in cadaver bones[J].Clin Biomech,2004,19(5):506-512.
• [15]Varga P,Hofmann-Fliri L,Blauth M,et al.Prophylactic augmentation of the osteoporotic proximal femur-mission impossible[J].Bonekey Reports,2016,5:854-856.