van Loon C J, de Waal Malefijt M C, Veth R P
Academisch Ziekenhuis, afd. Orthopedie, Nijmegen.
Ned Tijdschr Geneeskd. 1994 Sep 3;138(36):1810-3.
Evaluation of the treatment of unstable pertrochanteric femoral fractures with a femoral head prosthesis in older patients.
Descriptive.
University Hospital Nijmegen, the Netherlands.
From January 1988 through December 1992, 15 patients with 15 unstable pertrochanteric femoral fractures were treated with a femoral head prosthesis and additional wiring of the trochanter. The group consisted of 11 women and 4 men with a mean age of 86 years. Two operations were secondary treatments after broken angled-plate fixation. The other 13 were primary treatments.
A stable fixation allowing weight-bearing was achieved in all cases. The operations were accompanied by high morbidity and mortality rates: 4 patients died within 3 months after surgery. One dislocation of the prosthesis occurred. Twelve fractures consolidated, pseudarthrosis of the greater trochanter occurred twice. Five patients regained their preoperative walking ability.
Femoral head prosthesis with additional wiring is an alternative with few mechanical complications in the treatment of unstable pertrochanteric femoral fractures.
评估在老年患者中使用股骨头假体治疗不稳定型股骨转子间骨折的效果。
描述性研究。
荷兰奈梅亨大学医学中心。
1988年1月至1992年12月，15例不稳定型股骨转子间骨折患者接受了股骨头假体置换及转子附加钢丝固定术。该组包括11名女性和4名男性，平均年龄86岁。2例为角钢板内固定失败后的二次手术，其余13例为初次手术。
所有病例均实现了稳定固定并允许负重。手术伴有较高的发病率和死亡率：4例患者在术后3个月内死亡。发生1例假体脱位。12例骨折愈合，大转子假关节形成2例。5例患者恢复了术前行走能力。
附加钢丝固定的股骨头假体是治疗不稳定型股骨转子间骨折的一种选择，机械并发症较少。
