应用半髋长柄假体加股骨粗隆捆绑固定方法治疗老年股骨粗隆间骨折体会

山 金(延边朝医医院，中国)
本江 邹(延边朝医医院，中国)

摘要

目的：探讨老年股骨粗隆间骨折人工股骨头置换术中应用生物性长柄假体加合适的粗隆骨折固定方法能恢复正常解剖结构及步行，且能恢复髋部生物力学作用。方法：2016年10月-2023年2月共60病例患者进行股骨粗隆间骨折人工股骨头置换术加粗隆骨折复位钢丝捆绑固定。随访55例患者6个月~2年。平均年龄为76岁（64~89岁）。用术前、术后及随访x线结果评估临床有效性。结果：人工股骨头置换术加粗隆骨折钢丝捆绑手术方法术后股骨粗隆间骨折复位满意，长柄假体加粗隆骨折捆绑技术能提供早期稳定性，患者能早期下地，缩短卧床时间，大大减少了术后不良并发症，提高生活质量，Harris评分（91±6）分。结论：人工股骨头置换术中应用生物性长柄加粗隆骨折钢丝捆绑方法治疗老年股骨粗隆间骨折效果临床显著

关键词

股骨粗隆间骨折；人工股骨头置换术；粗隆骨折；钢丝捆绑

参考

Harris WH.Traumatic of the hip after dislocation and acetabularfracture: treatmeant by mold arthroplasty[J].JBone Joint Surg(Am),1969,51:737-755.

Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. JArthroplasty. 2002;17(4 Suppl 1):17-22.

Anglen JO, Weinstein JN. Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database. J Bone Joint Surg Am. 2008;90:700-707.

Aros B, Tosteson AN, Gottlieb DJ, Koval KJ. Is a sliding hip screw or im nail the preferred implant for intertrochanteric fracture fixation? Clin Orthop Relat Res. 2008;466:2827-2832.

Kim SY, Kim YG, Hwang JK. Cementless calcar-replacement hemiarthroplasty compared with intramedullary fixation of unstable intertrochanteric fractures. A prospective,randomized study. J Bone Joint Surg Am. 2005;87:2186-2192.

Lee YK, Ha YC, Chang BK, Kim KC, Kim TY, Koo KH.Cementless bipolar hemiarthroplasty using a hydroxyapatitecoated long stem for osteoporotic unstable intertrochanteric fractures. J Arthroplasty. 2011;26:626-632.

Qi X, Zhang Y, Pan J, Ma L, Wang L, Wang J. Effect of bone cement implantation on haemodynamics in elderly patients and preventive measure in cemented hemiarthroplasty. Biomed Res Int. 2015;2015:568019.

Amstutz HC, Mai LL, Schmidt I. Results of interlocking wire trochanteric reattachment and technique refinements to prevent complications following total hip arthroplasty. Clin Orthop Relat Res. 1984;(183):82-89.

Koyama K, Higuchi F, Kubo M, Okawa T, Inoue A. Reattachment of the greater trochanter using the DallMiles cable grip system in revision hip arthroplasty. J Orthop Sci. 2001;6:22-27.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v7i12.22878