骨水泥加长柄人工股骨头置换治疗高龄不稳定性股骨转子间骨折-新.doc

骨水泥加长柄人工股骨头置换治疗高龄不稳定性股骨转子间骨折 柏文昆，鲁木，胡红耘 （淮南东方医院集团总院骨科 232001） 摘要：目的 评价骨水泥加长柄人工股骨头置换治疗高龄不稳定性股骨转子间骨折的临床疗效。 方法 98例高龄不稳定性股骨转子间骨折患者，女性60例，男性38例，年龄75-94岁，平均83.5岁。骨折按Tronzo-Evans分型I = 3 \* ROMAN II型56例， = 34 \* ROMAN IV型42例。均采用骨水泥加长柄人工股骨头置换的方法治疗，观察临床治疗效果。结果 所有病例术后X线片显示转子间骨折均复位固定良好，假体位置良好。术后96例获得6-24个月随访，平均15个月。Harris评分，优良率85.4％。结论 骨水泥加长柄人工股骨头置换术具有术后功能恢复快、负重活动早，可避免长期卧床并发症等优点，是治疗高龄不稳定性股骨转子间骨折较为合理的手术方法。 关键词：股骨转子间骨折；股骨头置换；高龄；不稳定骨折 Treatment of Unstable Femoral Fractures Between Rotor in Elderly Patients with Bone Cement Longer Handle Artificial Femoral Head Replacement BAI Wen-kun,LU Mu，HU Hong-yun (Huainan Oriental institute of orthopaedics hospital group 232001) Abstract: Objective To evaluate bone cement longer handle artificial femoral head replacement treatment the clinical effect of the treatment of femoral fractures between rotor - instability. Methods 98 patients with fracture of instability - between the femur rotor, women 60 cases, 38 cases, male, aged 75 to 94 years old, average 83.5 years. Fracture by Tronzo - Evans type III 56 cases, type IV 42 cases. All use of bone cement longer handle artificial femoral head replacement therapy, to observe clinical therapeutic effect . Results all cases of postoperative X-ray shows both fracture reduction and fixation well between the rotor and prosthesis position is good. 96 cases of postoperative for 6 to 24 months follow-up, the average 15 months. Harris score was 85.4%. Conclusion Bone cement longer handle artificial femoral head replacement has quick postoperative functional recovery, weight-bearing activities earlier, can avoid the advantages of long-term complications in bed, instability is treatment of older femoral fractures between rotor reasonable operation method. Key words: femoral fractures between rotor; Femoral head replacement; Old age;Unstable fractures. 股骨转子间骨折好发于老年患者，其中不稳定性骨折约占60.5％［1］。因多合并不同程度的内科疾病，保守治疗易发生髋内翻、下肢短缩外旋畸形，生活质量明显下降，且长期卧床牵引容易引起全身并发症，病死率较高［2］。国内外学者应用关节置换治疗高龄