Zhang Hua, Xu Zhongwei, Zhou Aiguo, Yan Wenlong, Zhao Pei, Huang Xiao, Zhang Jian
Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Medicine (Baltimore). 2017 Jan;96(1):e5614. doi: 10.1097/MD.0000000000005614.
The aim of this study was to evaluate the efficacy of supplementary fixation in hip arthroplasty with the use of Kirschner-wires and tension band for geriatric patients suffering unstable intertrochanteric osteoporotic fractures. A total of 103 patients aged more than 75 years were recruited. A bipolar or total hip replacement was performed with additional application of Kirschner-wires and tension band, and the participants were followed up for 2 to 11 years. Physical component summary (PCS), mental component summary (MCS), visual analog scale (VAS), and Harris hip score were utilized to evaluate patients' hip pain and function, as well as the mental condition postoperatively after 1.5 months, 3 months, 6 months, 1 year, and annually thereafter until the latest follow-up in 2015. Patients showed a significant improvement in all scores between 1.5 months and 1 year (P < 0.001), with the good efficacy lasting at least until the 2-year follow-up. None of the patients showed dislocation, implant loosening, or nonunion of the fracture throughout the follow-up period. In conclusion, it was beneficial to treat unstable intertrochanteric osteoporotic fractures in aged patients with hip arthroplasty coupled with Kirschner-wires and tension band.
本研究的目的是评估在老年不稳定型股骨转子间骨质疏松性骨折患者的髋关节置换术中使用克氏针和张力带进行辅助固定的疗效。共招募了103名年龄超过75岁的患者。进行双极或全髋关节置换，并额外应用克氏针和张力带，对参与者进行了2至11年的随访。使用身体成分总结（PCS）、心理成分总结（MCS）、视觉模拟量表（VAS）和Harris髋关节评分来评估患者的髋关节疼痛和功能，以及术后1.5个月、3个月、6个月、1年及此后每年直至2015年最新随访时的心理状况。患者在1.5个月至1年之间所有评分均有显著改善（P<0.001），良好疗效至少持续到2年随访。在整个随访期间，没有患者出现脱位、植入物松动或骨折不愈合。总之，对于老年不稳定型股骨转子间骨质疏松性骨折患者，采用髋关节置换术联合克氏针和张力带进行治疗是有益的。
