Hong Song, Lin Jia-Sheng, Zhou Yong, Zou Chang, Zhang Wen-Li, Duan Hong, Tu Chong-Qi
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Orthopedics, the Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2016 Jul;47(4):565-569.
To evaluate the clinical results of femoral proximal fracture with complex hip diseases using an uncemented extensively porous-coated long femoral stems.
15 cases of femoral proximal fracture with complex hip diseases treated with the uncemented extensively porous-coated long femoral stem were retrospectively reviewed. All patients were followed up at 1, 3, 6, 12 months in the first year postoperatively and once a year from the second year on.Radiological evaluations were conducted using the related criteria, including anteropostierior radiograph of pelvis, anteropostierior and lateral radiograph of proximal femur, and flat tomography of lower limbs.The bone union of the femur fracture, the fixation of prosthesis, and periprosthetic bone loss were evaluated by above-mentioned radiography.The subsidence of femoral prosthesis was compared between 1 month postoperatively and the last follow-up. Complications during the follow-up period was recorded.Clinical outcomes were assessed with Harris Hip Score the last follow-up, including excellent (90-100), good (80-89), moderate (70-79) and bad (<70).
The average follow-up period was (45.5±21.7) months. All fractures were united at mean 12.6 weeks. There were no femoral stem subsidence and evidence of loosening both radiologically and clinically. The reconstructive offset for femoral fracture was 35.8 mm, while the contralateral offset was 34.8 mm. The average Harris Hip Score was 89.5 at the last follow-up. Moreover, no loosening, dislocation or infection were observed.
Total hip arthroplasty with extensively porous-coated long femoral stem provides a good fracture stability that promotes fracture healing and offers a successful solution for femoral proximal fracture with complex hip diseases.
评估使用非骨水泥型大孔隙涂层长柄股骨柄治疗合并复杂髋部疾病的股骨近端骨折的临床效果。
回顾性分析15例使用非骨水泥型大孔隙涂层长柄股骨柄治疗的合并复杂髋部疾病的股骨近端骨折患者。所有患者术后第1年在1、3、6、12个月进行随访，从第2年起每年随访1次。采用相关标准进行影像学评估，包括骨盆前后位X线片、股骨近端前后位和侧位X线片以及下肢平扫断层扫描。通过上述影像学检查评估股骨骨折的骨愈合情况、假体固定情况及假体周围骨丢失情况。比较术后1个月与末次随访时股骨假体的下沉情况。记录随访期间的并发症。末次随访时采用Harris髋关节评分评估临床疗效，包括优（90 - 100分）、良（80 - 89分）、中（70 - 79分）和差（<70分）。
平均随访时间为（45.5±21.7）个月。所有骨折平均在12.6周时愈合。无论是影像学还是临床检查均未发现股骨柄下沉及松动迹象。股骨骨折的重建偏移为35.8 mm，对侧偏移为34.8 mm。末次随访时Harris髋关节评分平均为89.5分。此外，未观察到松动、脱位或感染情况。
采用大孔隙涂层长柄股骨柄的全髋关节置换术可提供良好的骨折稳定性，促进骨折愈合，为合并复杂髋部疾病的股骨近端骨折提供了成功的解决方案。
