Hammad Akram, Abdel-Aal Ahmed, Said Hatem G, Bakr Hatem
Orthopaedic Department, Mansoura University Hospital, Mansoura 35516, Egypt.
Acta Orthop Belg. 2008 Dec;74(6):788-92.
Thirty-two patients (11 male, 21 female) with a mean age of 64 years were prospectively studied after undergoing total hip replacement after failed treatment of intertrochanteric fractures. One patient had bilateral surgery. The mean time from primary surgery to the salvage arthroplasty was 15 months (range, 4 to 32 months). The mean follow-up period was 57 months (range, 30 to 108 months). Intraoperative femoral fracture occurred in one patient and postoperative dislocation in another. Three patients had deep venous thrombosis, two had gastrointestinal bleeding and one had a non fatal pulmonary embolism. At the last follow-up, we were able to review 26 patients with 27 arthroplasties; the other 6 patients had died. The majority had good pain relief and marked functional improvement. Twenty-two patients had either no or mild pain and 24 patients were able to walk freely with or without support. Almost 78% of patients had either excellent or good clinical results based on Harris hip score. Heterotopic ossification was noted in 8 hips. Total hip arthroplasty was found in this study to be an effective salvage procedure after failed treatment of intertrochanteric fracture in elderly patients.
32例患者（男11例，女21例），平均年龄64岁，在转子间骨折治疗失败后接受全髋关节置换术，进行前瞻性研究。1例患者接受双侧手术。初次手术至挽救性关节成形术的平均时间为15个月（范围4至32个月）。平均随访期为57个月（范围30至108个月）。1例患者术中发生股骨骨折，另1例术后发生脱位。3例患者发生深静脉血栓形成，2例发生胃肠道出血，1例发生非致命性肺栓塞。在最后一次随访时，我们能够对26例患者的27个关节成形术进行评估；另外6例患者已死亡。大多数患者疼痛缓解良好，功能明显改善。22例患者无疼痛或轻度疼痛，24例患者无论有无支撑都能自由行走。根据Harris髋关节评分，近78%的患者临床结果为优或良。8个髋关节出现异位骨化。本研究发现，全髋关节置换术是老年患者转子间骨折治疗失败后的一种有效的挽救手术。
