非水泥股骨假体置换治疗不稳定股骨粗隆间骨折Cementless femoral component used in hip arthroplasty for unstable intertrochanteric fracture in elderly
李军民;肖甲宇;贾福;张仲子;杨正宗;雷洲洋;
摘要(Abstract):
[目的]探讨个性化选择非水泥股骨假体柄髋关节置换术治疗老年不稳定股骨粗隆间骨折的临床疗效。[方法]回顾性分析2017年7月~2018年12月应用不同非水泥股骨假体柄行髋置换术治疗的61例(62髋)高龄股骨粗隆间骨折患者资料。[结果] 61例患者均顺利完成手术,无血管、神经损伤等术中并发症发生,手术时间为(55.48±10.61) min,术中出血量为(310.54±30.56) ml,术后下地行走时间为(4.82±0.58) d。患者随访12~28个月,平均(16.52±1.28)个月,术后完全负重时间为(56.71±6.86) d。随访期间无疼痛加重、脱位和死亡等并发症发生,无再次行翻修术者。髋关节功能Harris评分由术后6个月(84.28±3.83)分,提高到末次随访时(88.43±3.52)分,差异有统计学意义(P<0.001),髋关节功能得到极大的改善。影像方面,61例(62髋)患者股骨柄假体均即刻实现了生物压配,其中12例行全髋关节置换的患者髋臼杯实现了良好的生物压配。术后6个月按Engh固定/稳定标准评定股骨假体柄固定效果良好,所有患者均为稳定骨长入,未见假体松动征象。[结论]对于老年不稳定股骨粗隆间骨折,根据股骨近端髓腔的形态、骨的质量及骨折波及的范围,选择不同的非水泥股骨假体柄行人工髋关节置换术治疗,可获得良好的临床疗效。
关键词(KeyWords): 不稳定股骨粗隆间骨折;髋关节置换术;非水泥股骨柄;个性化选择;老年人
基金项目(Foundation): 云南省科技计划项目(编号:2017FE467-203)
作者(Author): 李军民;肖甲宇;贾福;张仲子;杨正宗;雷洲洋;
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