人工关节置换术治疗高龄股骨转子间粉碎性骨折

目的探讨人工关节置换术治疗高龄股骨转子间骨折的方法及疗效。方法对38例高龄（≥75岁）股骨转子间粉碎性骨折患者用骨水泥型人工髋关节置换术治疗,术中尽量复位大小转子并张力带钢丝固定。结果手术时间58~98 min,出血量200~380 ml。无切口感染及肺栓塞发生,2例出现尿道感染。患者均获随访,时间12~48个月。骨折愈合时间为3~6（4.5±0.5）个月。术后12个月Harris评分为76~94（84±3）分。结论人工关节置换术治疗高龄股骨转子间骨折患者手术时间短、出血少、可早期下地行走、关节功能恢复快、近期效果满意,是高龄股骨转子间骨折患者的一种理想手术方式,但掌握手术适应证及操作要点是关键。

Hip replacement for comminuted femoral intertrochanteric fractures in the elderly

Objective To discuss the clinical results of hip replacement for comminuted femoral intertrochanteric fractures in aged patients.Methods 38 cases（≥75 years old） of comminuted femoral intertrochanteric fractures underwent hip replacement of cemented hip replacement.The greater and lesser tuberosities were reduced and fixed with wire tension band.Results The operation time was 58~98 minutes,the intraoperative blood loss was 200~380 ml.No wound infection or pulmonary embolism were found.2 cases got involved with urinary tract infection.All patients were followed up for 12 to 48 months.The fracture healed in 3~6（4.5±0.5）months.After 12-month,the average Harris score was 76~94（84±3） points.Conclusions Hip replacement in treating intertrochanteric fractures of old age shows a limited bleeding and operating time consumption.It is effective for early function-training,fast recovery of joint function.However,the key is being aware of the indications for surgery and master of the surgical technique.