人工股骨头置换治疗股骨颈新鲜骨折随访5年疗效评价

目的 探讨人工股骨头置换术治疗股骨颈新鲜骨折的治疗效果.方法 分析了1995年12月～1998年1月采用人工股骨头置换治疗股骨颈新鲜骨折79例，男32例，女47例.骨折分型GardenⅡ型13例，GardenⅢ型38例，GardenⅣ型28例.单极股骨头46例，双极股骨头33例.结果 术后随诊3年～7年6月（平均4年8月）.按Harris标准评定疗效：单极股骨头置换优良率69.6%，双极股骨头置换优良率81.8%.X线片观察：单极股骨头置换组：髋臼磨损硬化14例（30.4%）,假体松动7例（39.1%）.双极股骨头置换组:髋臼磨损硬化4例(12.1%)，假体松动7例（21.2%）.结论 (1)对于老年人有移位的股骨颈骨折，股骨头置换为优先考虑的有效方法.(2)双极股骨头置换术疗效优于单极股骨头置换术.3.改进骨水泥制作和应用现代骨水泥充填技术固定假体可大大提高人工股骨头置换的长期疗效.

The Treatment of the Fresh Femoral Neck Fracture with Hemiarthroplasty

Objective To evaluate the effect of hemiarthroplasty for thetreatment of fresh fractures of the femoral neck.Methods 79 cases of the fresh femoral neck fractures treated by hemiartroplasty during December 1995 and January 1998 were reviewed.46 cases were treated by mono-polar hemiarthroplasty.33 cases were treated by bi-polar hemiarthroplasty.Results The postoperative follow-up was 3 years to 7.5 years(average 4 years and 8 months).69.6% of mono-polar hemiarthroplaty got a good result.Hip wearing were found in 14 cases.7 cases had prosthetic loosening.Hip wearing was found in 4 cases.The loosening cases were the same as the groud of mono-polar hemiarthroplasty.Conclousions (1)Hemiarthroplasty is the effective method to treat old patient with the femoral neck fractures.(2)Bi-polar hemiarthroplasty is better than mono-polar hemiarthroplasty.(3)The morden cemented technique can greatly improve the long term result of hemiarthroplasty.