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采用环扎钢丝技术的骨水泥型双极半髋关节置换术治疗老年不稳定型股骨粗隆间髋部骨折

Cemented bipolar hemiarthroplasty with a cerclage cable technique for unstable intertrochanteric hip fractures in elderly patients.

作者信息

Abdelkhalek Mostafa, Ali Ayman M, Abdelwahab Mohamed

机构信息

Department of Orthopedic Surgery, Mansoura University, Mansoura, Egypt.

出版信息

Eur J Orthop Surg Traumatol. 2013 May;23(4):443-8. doi: 10.1007/s00590-012-1006-z. Epub 2012 Jun 6.

Abstract

AIM

The purpose of this study is to evaluate the clinical and radiological outcomes of cemented bipolar arthroplasty as a primary treatment for unstable intertrochanteric fracture in the elderly patients.

METHODS

Twenty hips with unstable intertrochanteric fractures were followed for more than 2 years after cemented bipolar hemiarthroplasty. The mean age was 69 years, and the mean follow-up period was 30.5 months. We evaluated the results by Harris hip score, complications, and radiologic findings.

RESULTS

At the last follow-up, the mean Harris hip score was 83.3 points. Radiologically, there was no case of osteolysis. All stems were stable without significant changes in alignment or progressive subsidence.

CONCLUSIONS

Bipolar hemiarthroplasty with calcar reconstruction is a good option for unstable intertrochanteric fractures in elderly patients with severe osteoporosis with strict indication selection. Longer-term studies with larger numbers of patients are required to address the issues of late complications.

摘要

目的

本研究旨在评估骨水泥型双极人工关节置换术作为老年不稳定型转子间骨折主要治疗方法的临床和影像学结果。

方法

对20例接受骨水泥型双极半髋关节置换术的不稳定型转子间骨折患者进行了2年以上的随访。平均年龄为69岁,平均随访时间为30.5个月。我们通过Harris髋关节评分、并发症和影像学检查结果来评估疗效。

结果

在最后一次随访时,Harris髋关节平均评分为83.3分。影像学检查显示,无一例发生骨溶解。所有假体柄均稳定,对线无明显改变,也无进行性下沉。

结论

对于有严格适应证选择的重度骨质疏松老年不稳定型转子间骨折患者,带股骨距重建的双极半髋关节置换术是一个不错的选择。需要开展更多患者参与的长期研究来解决晚期并发症问题。

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