S. Kweon, C. Shin, Y. Lee, Min-Woo Kim, Tae-Ho Kim
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引用次数: 0
摘要
目的:评价采用抛光骨水泥股骨干双极半关节置换术治疗老年患者粗隆间骨折的临床和影像学结果。材料与方法:2005年7月至2015年5月,48例诊断为转子间骨折的患者行双极半关节置换术。平均年龄80.5岁,随访30.5个月。对术后结果进行临床和影像学评价。结果:平均手术时间100 min(范围90 ~ 120 min),平均失血量334 ml(范围170 ~ 500 ml)。在最后一次随访时,Harris髋关节评分(HHS)、视觉模拟评分(VAS)和Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)的平均评分分别为82.2(范围76-90)、0.8(范围1-3)和36(范围30-40)。步行开始使用助行器部分负重,平均步行时间为5.8天(范围3-14天)。36例(75.0%)患者恢复了损伤前的行走能力,12例(25.0%)患者可以使用轮椅行走。工具性日常生活活动(IADLs) 17例(35.4%),基本日常生活活动(BADLs) 31例(64.6%)。结论:抛光骨水泥双极半关节置换术可实现安全固定,术后无大腿疼痛。术前恢复行走能力对老年股骨粗隆间骨折患者更有帮助。
Clinical and Radiological Outcomes of Polished Cemented Bipolar Hemiarthroplasty for Intertrochanteric Fractures in Elderly Patients
Purpose: To evaluate the clinical and radiological outcomes of bipolar hemiarthroplasty using a polished cemented femoral stem for intertrochanteric fractures in elderly patients. Materials and Methods: From July 2005 to May 2015, 48 patients diagnosed with intertrochanteric fractures underwent bipolar hemiarthroplasty. The mean age and follow-up period were 80.5 years and 30.5 months, respectively. The postoperative results were evaluated clinically and radiologically. Results: The mean operation time was 100 minutes (range, 90-120 minutes), and the mean amount of blood loss was 334 ml (range, 170-500 ml). At the last follow-up, the mean Harris hip score (HHS), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 82.2 (range, 76-90), 0.8 (range, 1-3), and 36 (range, 30-40), respectively. Walking was initiated using a walker for partial weight-bearing, and the mean walking time was 5.8 days (range, 3-14 days). Ambulatory ability was restored to a walking state before the injury in 36 cases (75.0%), and wheelchair ambulation was possible in 12 cases (25.0%). The instrumental activities of daily living (IADLs) were 17 patients (35.4%), and the basic activities of daily living (BADLs) were 31 patients (64.6%). Conclusion: Polished cemented bipolar hemiarthroplasty can achieve secure fixation with no postoperative thigh pain. Restoring the preoperative walking ability will be more helpful for intertrochanteric fractures in elderly patients.