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接受血液透析患者髋部骨折的手术治疗

Operative treatment of hip fractures in patients receiving hemodialysis.

作者信息

Tosun Bilgehan, Atmaca Halil, Gok Umit

机构信息

School of Medicine, Department of Orthopaedics and Traumatology, Kocaeli University, Umuttepe Merkez Kampüsü, Umuttepe, Kocaeli, Turkey.

出版信息

Musculoskelet Surg. 2010 Nov;94(2):71-5. doi: 10.1007/s12306-010-0080-9. Epub 2010 Sep 30.

Abstract

Fifteen hips in 13 patients with hip fracture were treated in patients receiving hemodialysis for chronic renal failure. There were four intertrochanteric and 11 femoral neck fractures. 10 of the 11 femoral neck fractures and one of the four intertrochanteric fractures were treated with cemented bipolar hemiarthroplasty. Two intertrochanteric fractures fixed with sliding compression screws. External fixation was used for stabilization in two patients who had femoral neck and intertrochanteric fractures. Two intertrochanteric fractures that were treated with sliding hip screw showed radiological union postoperatively at the 6th month. Of the 11 hemiarthroplasty, four hips developed aseptic loosening (36%). According to Harris hip score grading system, three (37.5%) poor, two (25%) fair, two (25%) good and one (12.5%) case had excellent outcome in the hemiarthroplasty group. The survival of dialysis patients with a hip fracture is markedly reduced. Initial treatment of hemiarthroplasty allows early mobilization and prevents revision surgery.

摘要

13例髋部骨折患者的15个髋关节接受了治疗,这些患者因慢性肾衰竭正在接受血液透析。其中有4例粗隆间骨折和11例股骨颈骨折。11例股骨颈骨折中的10例以及4例粗隆间骨折中的1例采用骨水泥型双极半髋关节置换术治疗。2例粗隆间骨折采用滑动加压螺钉固定。2例同时患有股骨颈骨折和粗隆间骨折的患者采用外固定进行稳定治疗。2例采用滑动髋螺钉治疗的粗隆间骨折在术后6个月显示影像学愈合。在11例半髋关节置换术中,有4个髋关节出现无菌性松动(36%)。根据Harris髋关节评分系统,半髋关节置换术组中,3例(37.5%)为差,2例(25%)为一般,2例(25%)为良好,1例(12.5%)为优秀。髋部骨折的透析患者生存率明显降低。初次进行半髋关节置换术可使患者早期活动并避免翻修手术。

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