Gierer P, Landes J, Grubwinkler M, Gradl G, Lob G, Andress H J
Klinik und Poliklinik für Chirurgie, Abteilung für Unfall- und Wiederherstellungschirurgie, Universität Rostock, Germany.
Zentralbl Chir. 2002 Jun;127(6):514-8. doi: 10.1055/s-2002-32612.
This is a report on the treatment results of femoral neck fractures with a cemented (group 1) and cementless (group 2) type of hip prosthesis, resp. 72 patients were enrolled. 35 patients were treated with a cemented hip prosthesis (mean age: 78 years), and 37 patients with a cementless modular hip prosthesis (mean age: 77 years). In the cemented group we observed 5 cases of hypotension during insertion of the prosthesis in the femoral shaft. One of these patients required mechanical resuscitation during surgery. In the second group 3 cases of proximal femur fissure and one case of distal femoral fracture were recorded. One year after surgery 43 patients presented for follow up evaluation (cemented group: n = 24; cementless group: n = 19). Both groups revealed comparable results according to the Harris Hip Score (75 versus 78,3 points). No prosthesis loosening was observed in either group. In our view the cemented hip prosthesis is the treatment of choice for femoral neck fractures among the old and very old, if no stabile osteosynthesis can be performed. Patients with cardiopulmonary risk factors, however, may profit from cementless hip arthroplasty to avoid the well known cardiodepression during surgery.
这是一份关于分别使用骨水泥型（第1组）和非骨水泥型（第2组）髋关节假体治疗股骨颈骨折的结果报告。共纳入72例患者。35例患者接受骨水泥型髋关节假体治疗（平均年龄：78岁），37例患者接受非骨水泥型模块化髋关节假体治疗（平均年龄：77岁）。在骨水泥型组中，我们观察到在股骨干假体植入过程中有5例出现低血压。其中1例患者在手术期间需要机械复苏。在第二组中，记录到3例股骨近端裂缝和1例股骨远端骨折。术后一年，43例患者前来进行随访评估（骨水泥型组：n = 24；非骨水泥型组：n = 19）。根据Harris髋关节评分，两组结果相当（75分对78.3分）。两组均未观察到假体松动。我们认为，对于年龄较大和非常大的股骨颈骨折患者，如果无法进行稳定的骨合成，骨水泥型髋关节假体是首选治疗方法。然而，有心肺危险因素的患者可能从非骨水泥型髋关节置换术中获益，以避免手术期间众所周知的心脏抑制。
