Pongkunakorn Anuwat, Thisayukta Phornphinit, Palawong Pattanapong
Department of Orthopaedic Surgery, Lampang Hospital and Medical Education Center, Lampang, Thailand.
J Med Assoc Thai. 2009 Dec;92 Suppl 6:S232-8.
Cemented hemiarthroplasty is the common treatment of femoral neck fracture in elderly patients. The authors had invented Lampang cement gun (LCG) from a caulking gun to improve cementing technique. There was no previous study about LCG in clinical use.
To describe invention technique and evaluate clinical result of using LCG for cemented hemiarthroplasty in elderly patients with femoral neck fracture.
A retrospective study was conducted on 96 elderly patients who underwent cemented hemiarthroplasty (58 Austin Moore, 14 Thompson, 24 bipolar) in Lampang Hospital between October 2003 and April 2008. The femoral canal was filled with cement by using LCG Clinical outcome was assessed by Harris hip score (HHS). Radiographic quality of cementing technique was evaluated by Barrack's grading system.
The mean age of the patients was 76 years (range, 62-96) and follow-up period was 39 months (range, 12-66). Twenty-four patients died and five were lost to follow-up. The mean HHS in bipolar group was higher than Thompson and Austin Moore groups (83.2, 78.3 and 76.9 respectively). Excellent and good scores were found in 90.9% of bipolar hips compared with 46.7% in unipolar hips. Less than 10% of the patients had poor clinical result. Cement mantles was grade A 37.3%, B 32.8%, C 20.9% and D 9%. Probably loose was found in one grade-D hip. Two grade-D hips were removed due to infection and dislocation. One grade-C hip was revised due to periprosthetic fracture. The mortality rate at 36 months was 20.8% in unipolar and 8.3% in bipolar group.
The use of LCG for cemented hemiarthroplasties in elderly patients with femoral neck fracture provided satisfactory clinical outcome. LCG could be used to improve cementing technique and save the operative cost.
骨水泥半髋关节置换术是老年股骨颈骨折的常见治疗方法。作者从填缝枪发明了南邦骨水泥枪（LCG）以改进骨水泥技术。此前尚无关于LCG临床应用的研究。
描述发明技术并评估在老年股骨颈骨折患者中使用LCG进行骨水泥半髋关节置换术的临床结果。
对2003年10月至2008年4月期间在南邦医院接受骨水泥半髋关节置换术（58例奥斯汀·摩尔型、14例汤普森型、24例双极型）的96例老年患者进行回顾性研究。使用LCG向股骨髓腔内注入骨水泥。通过Harris髋关节评分（HHS）评估临床结果。采用Barrack分级系统评估骨水泥技术的影像学质量。
患者平均年龄76岁（范围62 - 96岁），随访期39个月（范围12 - 66个月）。24例患者死亡，5例失访。双极型组的平均HHS高于汤普森型组和奥斯汀·摩尔型组（分别为83.2、78.3和76.9）。双极型髋关节90.9%的评分优良，而单极型髋关节为46.7%。不到10%的患者临床结果较差。骨水泥壳分级为A级占37.3%，B级占32.8%，C级占20.9%，D级占9%。1例D级髋关节发现可能松动。2例D级髋关节因感染和脱位而取出。1例C级髋关节因假体周围骨折而翻修。单极型组36个月时的死亡率为20.8%，双极型组为8.3%。
在老年股骨颈骨折患者中使用LCG进行骨水泥半髋关节置换术可提供满意的临床结果。LCG可用于改进骨水泥技术并节省手术成本。
