Vanclooster P, Broos P, Rommens P, Gruwez J A
Department of General Surgery and Traumatology, Katholieke Universiteit Leuven.
Acta Chir Belg. 1988 Jan-Feb;88(1):21-5.
Between July 1981 and July 1986, 152 patients with an unstable, intracapsular fracture of the femoral neck were treated with a prosthetic replacement. In a selected group of 75 very old individuals, with an average age of 82 years, a self-locking cephalic endoprosthesis was chosen. These patients were closely followed prospectively, during 3 months. The operative technique, the pre- and postoperative management are discussed. There was no peroperative mortality. The postoperative mortality rate (30 days) was very low (5.3%). Accidental fracture of the proximal femoral shaft occurred twice, during insertion of the prosthesis. No postoperative luxation was seen. The walking capacity of the survivors, 3 months after surgery, was compared with the status before injury. The self-locking cephalic endoprosthesis is a safe and time-economizing operative procedure. In our opinion, it is the treatment of choice for unstable, medial neck fractures of the femur in elderly patients, with a poor general condition and a limited life expectancy.
1981年7月至1986年7月期间，152例股骨颈囊内不稳定骨折患者接受了假体置换治疗。在一组选定的75例高龄患者中，平均年龄为82岁，选用了自锁式股骨头假体。对这些患者进行了为期3个月的前瞻性密切随访。讨论了手术技术、术前和术后管理。术中无死亡病例。术后30天死亡率极低（5.3%）。在假体植入过程中，股骨干近端意外骨折发生了两次。未观察到术后脱位。将幸存者术后3个月的行走能力与受伤前的状况进行了比较。自锁式股骨头假体是一种安全且节省时间的手术方法。我们认为，对于一般状况较差、预期寿命有限的老年患者股骨内侧颈不稳定骨折，它是首选的治疗方法。
