Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
Department of Orthopedics and Traumatology, Central Finland Hospital, Jyväskylä, Finland.
Scand J Surg. 2019 Dec;108(4):321-328. doi: 10.1177/1457496918812226. Epub 2018 Nov 25.
Hemiarthroplasty is a common method of treating displaced femoral neck fractures, especially among elderly non-active patients with frailty syndrome. Complications arising from the use of a modern, modular hemiendoprosthesis via a posterior approach have been poorly reported in this population. The aim of this study was to evaluate complications and mortality associated with the use of Lubinus sp II cemented, unipolar hemiarthroplasty prosthesis and posterior approach during a 9-year follow-up.
All patients (244) who received hemiarthroplasty due to an acute fracture of the femoral neck in Central Finland Hospital, Jyvaskyla, Finland, during 2007 and 2008 were included. Patient records were retrospectively reviewed for intraoperative and postoperative complications.
Women composed 70% (n = 171) of the study population. Mean age was 83 years for women and 80 years for men. A total of 31 (12%) complications were found in 30 patients. These were 12 dislocations (5% of all patients), 5 (2%) periprosthetic fractures, 2 (0.8%) superficial and 5 (2%) deep infections, 1 (0.4%) protrusion of the prosthesis, 2 (0.8%) intraoperative fractures, and 2 (0.8%) partial sciatic nerve palsies. Conversion to total hip replacement was performed in 9 cases (4%) and a reoperation was required in 15 (6%) cases. Mortality rate at 9 years was 78% (95% confidence interval = 72%-83%). The overall rate of complications was acceptable although mortality was high in this comorbid patient population. The need for conversion to total hip arthroplasty and reoperation is low.
人工股骨头置换术是治疗移位性股骨颈骨折的常用方法，尤其适用于伴有虚弱综合征的老年非活动患者。通过后路使用现代模块化半髋关节假体的相关并发症在该人群中报道较少。本研究旨在评估使用 Lubinus sp II 水泥型单极人工股骨头置换术和后路治疗 9 年随访期间的相关并发症和死亡率。
所有因急性股骨颈骨折于芬兰于韦斯屈莱中央医院（Jyväskylä，芬兰）在 2007 年至 2008 年接受人工股骨头置换术的患者（244 例）均纳入本研究。回顾性分析患者的术中及术后并发症。
研究人群中女性占 70%（n = 171）。女性的平均年龄为 83 岁，男性为 80 岁。共发现 30 例患者中有 31 例（12%）并发症。这些并发症包括 12 例脱位（所有患者的 5%）、5 例（2%）假体周围骨折、2 例（0.8%）浅表感染和 5 例（2%）深部感染、1 例（0.4%）假体突出、2 例（0.8%）术中骨折和 2 例（0.8%）部分坐骨神经麻痹。9 例（4%）患者改行全髋关节置换术，15 例（6%）患者需要再次手术。9 年时的死亡率为 78%（95%置信区间为 72%-83%）。虽然该合并症患者群体的死亡率较高，但总的并发症发生率是可以接受的。需要转换为全髋关节置换术和再次手术的比例较低。
