Szczesny Grzegorz, Górski Radosław, Biedrzycki Jerzy, Górecki Andrzej
Katedra i Klinika Ortopedii i Traumatologii Narzadu Ruchu, Warszawski Uniwersytet Medyczny, Warszawa.
Chir Narzadow Ruchu Ortop Pol. 2009 Nov-Dec;74(6):337-40.
Successful operative stabilization of the comminuted, trochanteric fractures in elderly patients is problematic due to advanced osteoporosis and poor physical activity excluding the cooperation in the postoperative rehabilitation. Stable fixation with dynamic hip screw or gamma nail, or flexible Ender nailing requires relieve of load during forthcoming several postoperative weeks needed for bone union, that reduced their usefulness in elderly patients. The aim of study was to analyze the usefulness of the cemented hemiartrhoplasty for the treatment of patients with comminuted trochanteric fractures. We analyzed 18 patients (16 women and 2 men, aged 69- 93-years-old (mean 83.3 years) treated in our Department in 2007 with cemented hemiathroplasty due to comminuted trochanteric fractures. Patients were intensively rehabilitated bearing their body weights from 3rd-5th, and consequently discharged on 9th-12th postoperative day. Due to the possibility of almost immediate mobilization in the postoperative period, cemented hemiathroplasty could be a method of choice for the treatment of the comminuted trochanteric fractures in elderly patients.
由于存在严重骨质疏松且身体活动能力差，排除术后康复中的配合因素，老年患者粉碎性转子间骨折的手术稳定治疗存在问题。使用动力髋螺钉或伽马钉进行稳定固定，或使用弹性恩德比钉，在骨愈合所需的术后几周内需要减轻负荷，这降低了它们在老年患者中的实用性。本研究的目的是分析骨水泥半关节成形术治疗粉碎性转子间骨折患者的实用性。我们分析了2007年在我院接受骨水泥半关节成形术治疗粉碎性转子间骨折的18例患者（16例女性和2例男性，年龄69 - 93岁，平均83.3岁）。患者在术后第3至5天开始负重并进行强化康复，随后在术后第9至12天出院。由于术后几乎可以立即活动，骨水泥半关节成形术可能是治疗老年患者粉碎性转子间骨折的一种选择方法。
