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半髋关节置换术与全髋关节置换术治疗复发性股骨转子间骨折:病例报告

Hemiarthroplasty Versus Total Hip Arthroplasty for Recurrent Intertrochanteric Fracture: A Case Report.

作者信息

Gerges Paul, Rios Ricardo, Lee Vincent, George Mary, Rizk Ralph

机构信息

Medicine, Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, USA.

Medicine, Edward Via College of Osteopathic Medicine - Auburn Campus, Auburn, USA.

出版信息

Cureus. 2025 Jul 26;17(7):e88815. doi: 10.7759/cureus.88815. eCollection 2025 Jul.

Abstract

Intertrochanteric fractures in elderly patients present a significant challenge, particularly when prior fixation has failed. Surgical management options include hemiarthroplasty and total hip arthroplasty (THA), with the choice influenced by factors such as patient age, functional status, and bone integrity. Hemiarthroplasty replaces only the femoral head, whereas THA replaces both the femoral head and the acetabulum. As a less invasive option, hemiarthroplasty may be preferred for older, medically frail patients. This case report discusses an 89-year-old man with a history of open reduction and internal fixation (ORIF) for an intertrochanteric fracture who presented with a recurrent fracture and implant failure. Given his advanced age and functional needs, hemiarthroplasty was selected over THA. The procedure was performed using a posterior approach, balancing the benefits of surgical exposure with the risks of dislocation. This case highlights the decision-making process involved in choosing hemiarthroplasty over THA and compares the benefits and limitations of each procedure.

摘要

老年患者的粗隆间骨折是一项重大挑战,尤其是在先前的固定失败时。手术治疗选择包括半髋关节置换术和全髋关节置换术(THA),选择受患者年龄、功能状态和骨质完整性等因素影响。半髋关节置换术仅置换股骨头,而THA则同时置换股骨头和髋臼。作为一种侵入性较小的选择,半髋关节置换术可能更适合年龄较大、身体虚弱的患者。本病例报告讨论了一名89岁男性,他曾因粗隆间骨折接受切开复位内固定术(ORIF),现出现复发性骨折和植入物失败。鉴于其高龄和功能需求,选择了半髋关节置换术而非THA。手术采用后入路进行,在手术暴露的益处与脱位风险之间进行权衡。本病例突出了在选择半髋关节置换术而非THA时所涉及的决策过程,并比较了每种手术的利弊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c0c/12377518/c48ad0d6952d/cureus-0017-00000088815-i01.jpg

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