Pryor G A
Department of Orthopaedics, Peterborough District Hospital, UK.
Injury. 1990 Nov;21(6):361-5. doi: 10.1016/0020-1383(90)90119-f.
The Moore and Thompson hemiarthroplasties are still commonly used for the displaced subcapital fracture in the elderly. The cemented Thompson has been claimed to be superior to the uncemented Moore prosthesis. However, the use of cement is associated with greater risks and the uncemented Moore appears to give good results in approximately two-thirds of patients. The technical adequacy of uncemented hemiarthroplasty has rarely been considered in assessing the outcome. This study indicates that, on the basis of four radiological criteria, incorrect insertion of the prosthesis leads to a high chance of a poor clinical result at 6 months. Good results are more likely when the postoperative radiograph shows the prosthesis to have been inserted accurately. This is possible in most cases, except where the femur is grossly osteoporotic with a wide intramedullary canal. Uncemented hemiarthroplasty can produce satisfactory results but, like uncemented total joint replacement, is a more demanding procedure.
穆尔（Moore）半髋关节置换术和汤普森（Thompson）半髋关节置换术仍常用于治疗老年人移位性股骨头下骨折。骨水泥固定的汤普森假体被认为优于非骨水泥固定的穆尔假体。然而，使用骨水泥会带来更大的风险，并且非骨水泥固定的穆尔假体在大约三分之二的患者中似乎能取得良好效果。在评估结果时，很少考虑非骨水泥半髋关节置换术的技术是否恰当。本研究表明，根据四项影像学标准，假体植入不当会导致6个月时临床效果不佳的可能性很高。当术后X线片显示假体植入准确时，更有可能获得良好效果。在大多数情况下这是可行的，除非股骨严重骨质疏松且髓腔宽大。非骨水泥半髋关节置换术可以产生满意的效果，但与非骨水泥全关节置换一样，是一种要求更高的手术。
