Mao Qiang, Zhang Yi, Hua Jiang, He Bangjian
Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, China.
The Zhejiang Chinese Medicine University, Hangzhou, China.
Geriatr Orthop Surg Rehabil. 2023 Jun 18;14:21514593231184314. doi: 10.1177/21514593231184314. eCollection 2023.
To analyze the clinical effect and imaging data of cementless bipolar hemiarthroplasty employing a long femoral stem (peerless-160) and 2 reconstructed femoral titanium wires to repair intertrochanteric fractures among the octogenarians.
Between June 2014 and August 2016, 58 octogenarians with femoral intertrochanteric fractures underwent the long femoral stem (peerless-160) cementless bipolar hemiarthroplasty by the same surgeon. We assessed clinical and radiological outcomes such as operative time, bleeding volume, blood transfusion volume, length of hospital stay, full weight-bearing walking time, walking ability calculated by Koval classification and Harris Hip Score (HHS), including fracture healing and greater trochanter fragments subsidence.
The surgery was successfully performed in all patients. The average operation time was 72.8 ± 13.2 min, the average blood loss during surgery was 225.0 ± 91.4 mL, 200 mL of blood was transfused, the mean duration of hospitalization was 11.9 ± 4.0 days, the mean time of full weight bearing was 12.5 ± 3.8 days. Patients were followed up for 24-68 months, averagely 49.4 ± 10.3 months. During follow-up, 4 (6.9%) patients died, and 1 (1.7%) was completely lost to ask about the recent situation. The average Harris Hip Score at the last follow-up was 87.8 ± 6.1, most of the patients recovered walking ability, under radiological examination, the prosthesis showed no signs of loosening. All trochanteric fractures gradually healed, the clinical and radiographic signs of healing occurred at average of 4.0 ± 1.1 months postoperatively.
For osteoporotic unstable intertrochanteric fractures in octogenarians, this study confirmed that the Cementless Bipolar Hemiarthroplasty Using a Long Femoral stem (peerless-160) with double cross binding technique is a satisfactory and safe choice for the octogenarians.
分析采用长柄股骨柄（无双-160）和两根重建股骨钛缆的非骨水泥型双极半髋关节置换术修复高龄患者股骨转子间骨折的临床疗效及影像学资料。
2014年6月至2016年8月，58例高龄股骨转子间骨折患者由同一外科医生行长柄股骨柄（无双-160）非骨水泥型双极半髋关节置换术。我们评估了手术时间、出血量、输血量、住院时间、完全负重行走时间、根据科瓦尔分类法计算的行走能力以及哈里斯髋关节评分（HHS）等临床和影像学结果，包括骨折愈合情况及大转子骨折块下沉情况。
所有患者手术均成功完成。平均手术时间为72.8±13.2分钟，术中平均失血量为225.0±91.4毫升，输血200毫升，平均住院时间为11.9±4.0天，平均完全负重时间为12.5±3.8天。患者随访24 - 68个月，平均49.4±10.3个月。随访期间，4例（6.9%）患者死亡，1例（1.7%）失访无法询问近期情况。末次随访时平均哈里斯髋关节评分为87.8±6.1，大多数患者恢复了行走能力，影像学检查显示假体无松动迹象。所有转子间骨折均逐渐愈合，愈合的临床和影像学征象平均在术后4.0±1.1个月出现。
对于高龄骨质疏松性不稳定股骨转子间骨折，本研究证实采用长柄股骨柄（无双-160）并结合双交叉捆绑技术的非骨水泥型双极半髋关节置换术是高龄患者一种满意且安全的选择。
