Dung Tran Trung, Hieu Nguyen Dinh, Son Le Manh, Dinh Thien Chu, Dinh Toi Chu
Department of Orthopaedic and Sport Medicine, Saint Paul Hospital, Hanoi, Vietnam.
Department of Orthopaedic and Neurosurgery, Hanoi Medical University Hospital, Hanoi, Vietnam.
Open Access Maced J Med Sci. 2019 Dec 20;7(24):4342-4346. doi: 10.3889/oamjms.2019.388. eCollection 2019 Dec 30.
Intertrochanteric fracture (ITF) is a major part of fracture in femoral head fracture. 95% of ITF are found in elderly patients. Osteosynthese is the preferred method of choice. However, elderly patients had osteoporotic, combined with many of chronic disease conditions that increase the rate of osteosynthese failure. Hemiarthroplasty bipolar long-stem is a surgical method that helps patients relieve pain, facilitate early rehabilitation, limit long-term complications, and improve quality of life for patients.
The aim of our study is to evaluate the clinical of result of primary cementless bipolar long stem hemiarthroplasty in treatment for unstable ITF in the elderly patients who have severe osteoporosis.
Between 01/2016 and 12/2017, 35 patients with ITF type A2.2 and A2.3 (AO) were included in our prospective study. These patients were over 70 years old and treatment by hemiarthroplasty cementless long stem at E hospital and Saint Paul hospital by one group surgeons.
Mean age of studied subjects was 84.29 ± 6.17, the lowest was 71, the highest was 96; ratio male/female was 1/4. Follow-up of 35 patients for at least 6 months showed 88.6% caused by a low-energy injury; Average rehabilitation time was 4.63 ± 1.7 days. The average Harris point at the end was 90.4 ± 4.72.
Primary cementless bipolar long stem hemiarthroplasty is one of good choices in treatment unstable ITF in elderly patients with severe osteoporosis helped patients improve the quality of life.
转子间骨折（ITF）是股骨头骨折的主要组成部分。95%的ITF发生于老年患者。接骨术是首选的治疗方法。然而，老年患者存在骨质疏松，且合并多种慢性疾病，这增加了接骨术失败的几率。双极长柄半髋关节置换术是一种手术方法，可帮助患者缓解疼痛，促进早期康复，减少长期并发症，并提高患者的生活质量。
本研究的目的是评估初次非骨水泥型双极长柄半髋关节置换术治疗老年严重骨质疏松不稳定型ITF的临床效果。
2016年1月至2017年12月，35例A2.2型和A2.3型（AO）ITF患者纳入我们的前瞻性研究。这些患者年龄超过70岁，由一组外科医生在E医院和圣保罗医院采用非骨水泥长柄半髋关节置换术进行治疗。
研究对象的平均年龄为84.29±6.17岁，最小71岁，最大96岁；男女比例为1/4。35例患者至少随访6个月，结果显示88.6%由低能量损伤引起；平均康复时间为4.63±1.7天。末次随访时Harris评分平均为90.4±4.72分。
初次非骨水泥型双极长柄半髋关节置换术是治疗老年严重骨质疏松不稳定型ITF的较好选择之一，有助于提高患者生活质量。
