关节置换联合钢板固定治疗老年股骨粗隆间骨折△

Joint replacement combined with plate fixation for intertrochanteric fractures in elderly

摘要:

［目的］探讨关节置换联合钢板固定治疗老年股骨粗隆间骨折的临床疗效。［方法］对 18 例老年股骨粗隆间骨折患者采用髋关节置换联合尺骨鹰嘴锁定钢板固定股骨大粗隆治疗。［结果］18 例患者均顺利完成手术，无严重术中并发症。围手术期无心脑血管事件、肺栓塞、死亡等严重并发症。所有患者均获随访 12 个月以上，术后完全负重时间（39.65±2.56）d。髋关节 Harris 评分由术后 6 个月的 （81.27±2.82） 分，提高到末次随访时的 （87.87±3.25） 分，差异有统计学意义 （P<0.05）。末次随访时，17 例恢复伤前活动水平和日常行为能力，1 例未能完全恢复至伤前活动水平。随访期间无假体松动、脱位、骨折不愈合、钢板螺钉松动和断裂等并发症。［结论］髋关节置换联合尺骨鹰嘴锁定钢板固定股骨大粗隆治疗老年股骨粗隆间骨折疗效满意，术后下地行走活动时间早，并发症少。

Abstract:

[Objective] To explore the clinical outcomes of joint replacement combined with plate fixation for intertrochanteric frac- tures in the elderly. [Methods] A retrospective study was done on 18 elderly patients who received hip replacement combined with olecra- non locking plate fixation for femoral intertrochanteric fractures. [Results] All the 18 patients were successfully operated on without serious complications, such as cardiovascular events, pulmonary embolism and death happened in anyone of them during the perioperative period. All patients were followed up for more than 12 months, and resumed full weight-bearing activity in (39.65±2.56) days. The Harris score in- creased from (81.27±2.82) at 6 months after operation to (87.87±3.25) at the latest follow-up, which was statistically significant (P＜0.05) . At the last follow-up, 17 patients returned to their pre-traumatic activity and daily life level, whereas 1 patient did not fully return to the pre-traumatic activity level. During the follow-up period, there were no complications such as prosthesis loosening, dislocation, fracture nonunion, plate screw loosening and refracture. [Conclusion] This hip replacement combined with olecranon locking plate fixation for femo- ral intertrochanteric fractures in the elderly does get satisfactory outcomes, with early postoperative ambulation and fewer complications.