Zhang Shixiong, Ma Jianxiong, Lu Bin, Ma Xinlong
Tianjin University Tianjin Hospital (Tianjin Hospital), Tianjin, 300211, P. R. China.
Tianjin Institute of Orthopedics, Tianjin, 300050, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Sep 15;38(9):1143-1148. doi: 10.7507/1002-1892.202402067.
To summarize the latest research progress of bone cement type femoral head replacement in the treatment of unstable intertrochanteric fractures in elderly patients.
The literature on the application of bone cement type femoral head replacement for unstable intertrochanteric fractures in elderly patients both domestically and internationally was reviewed, and the findings in aspects of selection of prosthesis types, proximal femoral reconstruction methods, postoperative complications, and rehabilitation were summarized and analyzed.
The bone cement type femoral head replacement has shown significant effectiveness in the treatment of unstable intertrochanteric fractures in elderly patients. The surgery provides immediate stability, allowing patients to quickly bear weight and regain walking function, thereby reducing the incidences of postoperative complications and mortality. However, due to the generally poor physical condition and low surgical tolerance of elderly patients, the risk of postoperative complications significantly increases, which has a significant impact on patients' postoperative recovery. Common complications include deep vein thrombosis, bone cement implantation syndrome, joint dislocation, prosthesis loosening, and periprosthetic fractures. Therefore, despite the apparent short-term effectiveness of the surgery, it is crucial to emphasize the prevention and management of postoperative complications to improve the long-term prognosis of elderly patients.
For unstable intertrochanteric fractures in elderly patients, when choosing bone cement type femoral head replacement, it is necessary to strictly adhere to surgical indications, reduce the occurrence of complications, and improve the patients' quality of life through refined preoperative evaluation, intraoperative operation, and effective postoperative management.
总结骨水泥型股骨头置换术治疗老年不稳定型股骨粗隆间骨折的最新研究进展。
回顾国内外关于骨水泥型股骨头置换术应用于老年不稳定型股骨粗隆间骨折的文献,总结并分析在假体类型选择、股骨近端重建方法、术后并发症及康复等方面的研究结果。
骨水泥型股骨头置换术在治疗老年不稳定型股骨粗隆间骨折方面显示出显著疗效。该手术能提供即刻稳定性,使患者能迅速负重并恢复行走功能,从而降低术后并发症发生率及死亡率。然而,由于老年患者身体状况普遍较差且手术耐受性低,术后并发症风险显著增加,这对患者术后恢复有重大影响。常见并发症包括深静脉血栓形成、骨水泥植入综合征、关节脱位、假体松动及假体周围骨折。因此,尽管该手术短期疗效明显,但强调术后并发症的预防和处理对于改善老年患者的长期预后至关重要。
对于老年不稳定型股骨粗隆间骨折,选择骨水泥型股骨头置换术时,需严格把握手术适应证,减少并发症发生,通过精细的术前评估、术中操作及有效的术后管理提高患者生活质量。