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[采用模块化半髋关节置换术(费尼克斯)治疗股骨颈骨折的早期结果]

[Early result of femur neck fracture treated with modular hemiarthroplasty fenix].

作者信息

Deszczyński Jarosław, Mikusek Rafał, Pisarski Artur, Stolarczyk Artur, Nowak Piotr

机构信息

Klinika Ortopedii i Rehabilitacji II Wydziału Lekarskiego, Warszawski Uniwersytet Medyczny.

出版信息

Chir Narzadow Ruchu Ortop Pol. 2009 Sep-Oct;74(5):266-71.

Abstract

The aim of the study is clinical assessment of modular arthroplasty Fenix and early assessment of 77 patient with femoral neck fracture treated with Fenix hemiarthroplasty. The mean age of the group was 77 years. There were 51 woman and 16 men in the group. Size of the used steam and head, the way of steam implantation, time of the operation and early complication was assessed. Operated patients were evaluated with Harris Hip Score, Larson I and Larson II score. The most common used steams were number 3 and 4, and the most common used head was number 44 with -4 mm offset. Mean operation time was 68.9 minute. The following early complication occurs: superficial wound infection treated with antibiotics--8 cases, pneumonia--8 cases, urinary tract infection--6 cases, intra operative femur shaft fracture during steam implantation, treated with plate osetosynthesis--1 cases. There were 14 cases of death in the group. 22 patients were evaluated with HHS and Larson. Mean score in HHS was 71 point, in Larson I--76 point, in Larson II--72 point. There was found that operating technique is similar like in the others hemiarthroplasty system and system is easy to use. Most of the stems were cemented. There was found that there are a high percent of death in femur neck fracture patient group during the first year after the operation and this kind of fractures handicap patient locomotion in spite of good hip joint function.

摘要

本研究的目的是对Fenix模块化关节成形术进行临床评估,并对77例接受Fenix半髋关节置换术治疗的股骨颈骨折患者进行早期评估。该组患者的平均年龄为77岁。其中女性51例,男性16例。评估了所用假体柄和股骨头的尺寸、假体柄植入方式、手术时间及早期并发症。对接受手术的患者采用Harris髋关节评分、Larson I和Larson II评分进行评估。最常用的假体柄型号为3号和4号,最常用的股骨头型号为44号,偏心距为-4mm。平均手术时间为68.9分钟。出现了以下早期并发症:经抗生素治疗的浅表伤口感染8例、肺炎8例、尿路感染6例、假体柄植入过程中术中股骨干骨折(采用钢板骨固定治疗)1例。该组有14例死亡。对22例患者进行了HHS和Larson评估。HHS平均评分为71分,Larson I为76分,Larson II为72分。发现该手术技术与其他半髋关节置换系统相似,且该系统易于使用。大多数假体柄采用骨水泥固定。发现股骨颈骨折患者组在术后第一年的死亡率较高,尽管髋关节功能良好,但这类骨折仍会妨碍患者的行动能力。

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