中国骨伤2017，Vol.30Issue(7)：591-596,6.DOI:10.3969/j.issn.1003-0034.2017.07.002
髋关节置换术治疗老年股骨转子间骨折内固定失败的中期随访
Mid-term follow-up study of hip arthroplasty for internal fixation failure of femoral intertrochanteric fractures in the elderly
摘要
Abstract
Objective:To retrospective analysis the mid-term follow-up effect of hip joint replacement in elderly patients with failure of intertrochanteric fractures of the hip joint internal fixation. Methods:From December 2008 to December 2011,32 elderly patients underwent arthroplasty after intertrochanteric fracture fixation failure ,of which,4 death cases were excluded from the study,and the remaining 28 cases were in the study group. The age of patients ranged from 69 to 83 years old with a mean of 75 years old. The time from the internal fixation to the hip replacement were 8 to 72 months. Among them ,6 pa-tients were EvansⅠ type,11 patients were Evans Ⅱtype,9 patients were Evans Ⅲ type,and 2 patients were Evans IV type. Nine cases showed fracture of the lateral plate before operation ,while 15 cases were femoral head screw cut-out and 4 cases were screw loosening. Harris score was used to compare the changes of hip function before operation with the final follow-up. Imaging results (X-ray) and erythrocyte sedimentation rate (ESR) were performed during the follow-up. Results:All patients were followed up from 4 to 7 years with an average of 5.3 years. Pain was significantly reduced or disappeared in patients com-pared with pre-operation. And hip function was significantly improved. Two cases had moderate pain after the physical activity and 4 cases had mild pain after the physical activity. At the final follow-up,19 patients resumed free walking,8 patients re-quired walking with walking sticks,and 1 patient needed walking aid. The Harris scores improved from preoperative 34.9±2.4 to 83.4±5.7 at the final follow-up,among them,15 cases were classified as excellent,10 as good,2 as fair,and 1 as poor. X-ray examination showed no prosthesis loosening and sinking fracture. Conclusion:Salvage THA surgery could improve the hip function and the quality of life for old patients with intertrochanteric fracture fixation failure ,and the middle-term follow-up re-sults support that.关键词
股骨骨折/骨折固定术,内/关节成形术,置换,髋Key words
Femoral fractures/Fracture fixation/internal/Arthroplasty/replacement/hip引用本文复制引用
孙启才,茹选良,钱志钢,吴立东,严世贵,王祥华..髋关节置换术治疗老年股骨转子间骨折内固定失败的中期随访[J].中国骨伤,2017,30(7):591-596,6.基金项目
浙江省医药卫生一般研究计划项目(编号:2014KYB010,2012KYB007) （编号:2014KYB010,2012KYB007）
浙江省中医药科技计划项目(编号:2017ZB003) （编号:2017ZB003）
General Research Project of Zhejiang Medical and Health (No.2014KYB010,2012KYB007) （No.2014KYB010,2012KYB007）
