| 人工股骨双动头置换治疗高龄不稳定型股骨转子间骨折的并发症分析 |
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投稿时间：2010-02-24 修订日期：2010-03-03
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 中文摘要:目的：分析人工股骨双动头置换治疗股骨转子间骨折的并发症及其原因。方法：2004年1月至2007年12月62例高龄不稳定型股骨转子间骨折采用人工股骨双动头置换，其中男34例，女28例；年龄81～97岁，平均86.3岁。按Evans分类法，Evans III型29例，Evans IV型26例， Evans V型7例。研究分析系统和局部并发症的发生情况。结果：59例出院后通过门诊获得随访，随访时间24～70个月，平均33个月。围手术期发生全身系统并发症19例，在院期间无死亡，院外死亡5人；手术局部相关并发症9例。其中包括大腿痛3例、医源性骨折1例、骨折延迟愈合2例、髋关节脱位2例、伤口浅表感染1例，无假体松动、假体周围感染、异位骨化或神经血管损伤。结论：人工股骨双动头置换术治疗股骨转子间骨折适用于80岁以上病人，因此在围手术期应尽可能纠正全身各器官及系统功能异常，同时，保留小粗隆并重建股骨距对改善假体周围生物力学及减少局部并发症具有重要意义。 |
| 【关键词】高龄 粗隆间骨折 人工股骨双动头置换 并发症 |
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| Complications of Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fracture of the Elderly |
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| ABSTRACT Objective: To analyze the complications of bipolar hemiarthroplasty for intertrochanteric fractures. Methods: 62 patients over 80 years old with unstable interthochanteric fracture were treated with bipolar hemiarthroplasty. The study included 34 males and 28 female with an average age of 86.3 (ranging from 81 to 97) in this study. In accordance to the Evans classification, there were 29 cases of Evans III, 26 Evans IV and 7 Evans V. The systemic and operation related complications were investigated. Results: 59 cases were followed up in outpatient department for 24-70 months (33 months on average). Systemic complications were found in 19 cases with no death during preoperative periods and 5 deaths after discharge from hospital. Operation related complications were demonstrated in 9 cases, which included 3 cases of thigh pain，1 iatrogenic fracture of proximal femur, 2 hip dislocation, 2 delayed union of fracture and 1 superficial infection. There were no aseptic loosening, periprosthetic infections, ectopic ossification or injuries of nerves and vessels happened. Conclusions: Bipolar hemiarthroplasty for intertrochanteric fracture is indicated for patients of more than 80 year old, thus the organic or systemic malfunctions should be corrected during perioperative period. Meanwhile, retaining of lesser trochanter and reconstruction of calcar femorale are of vital importance for improving periprosthetic biomechanics and reducing local complications. |
| KEY WORDS Elderly Intertrochanteric fractures Bipolar Hemiarthroplasty Complications |
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