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find Keyword "人工股骨头置换" 12 results
  • 人工股骨头置换治疗老年不稳定型股骨转子间骨折

    目的 总结人工股骨头置换治疗老年不稳定型股骨转子间骨折的临床疗效。 方法 2006 年9 月-2008 年2 月,对22 例老年不稳定型股骨转子间骨折行人工股骨头置换。男7 例,女15 例;年龄79 ~ 95 岁,平均83 岁。跌伤14 例,交通伤8 例。骨折按Evans 分型:Ⅱ型3 例,Ⅲ型11 例,Ⅳ型7 例,Ⅴ型1 例。16 例合并骨质疏松。受伤至手术时间为3 ~ 11 d,平均6 d。 结果 手术时间平均68 min,手术出血量平均260 mL。术后切口均Ⅰ期愈合,无下肢深静脉血栓、肺栓塞等并发症发生。22 例均获随访,随访时间9 ~ 25 个月,平均14 个月。术后3 个月采用Harris 评分评定髋关节功能:获优16 例,良4 例,可2 例,优良率91%。19 例随访1 年以上未见股骨假体松动、下沉,关节脱位及假体周围骨折。 结论 人工股骨头置换治疗老年不稳定型股骨转子间骨折,尤其是粉碎性骨折伴骨质疏松者,具有术后可早期下床锻炼,减少并发症发生的优点。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • COMPARISON OF EFFECTIVENESS OF THREE OPERATIONS IN TREATMENT OF DISPLACED FEMORAL NECK FRACTURES IN THE ELDERLY PATIENTS

    Objective To compare the effectiveness of internal fixation, hemiarthroplasty, and total hip arthroplasty in the treatment of displaced femoral neck fractures in elderly patients so as to provide the evidence for the selection of therapeutic methods. Methods Between May 2005 and April 2008, 108 elderly patients with displaced femoral neck fractures were treated by internal fixation with compression screw (IF group, n=31), hemiarthroplasty (HA group, n=37), and total hiparthroplasty (THA group, n=40). In IF group, there were 8 males and 23 females with an average age of 73 years (range, 65-80 years); fractures were caused by tumbl ing (25 cases) and traffic accident (6 cases), including 17 cases of Garden type III and 14 cases of Garden type IV; and the time from injury to operation ranged from 8 hours to 13 days with an average of 4.2 days. In HA group, there were 10 males and 27 females with an average age of 74 years (range, 65-80 years); fractures were caused by tumbl ing (29 cases) and traffic accident (8 cases), including 21 cases of Garden type III and 16 cases of Garden type IV; and the time from injury to operation ranged from 1 to 14 days with an average of 4.4 days. In THA group, there were 11 males and 29 females with an average age of 73 years (range, 66-80 years); fractures were caused by tumbl ing (32 cases) and traffic accident (8 cases), including 23 cases of Garden type III and 17 cases of Garden type IV; and the time from injury to operation ranged from 2 to 14 days with an average of 5.6 days. There was no significant difference in general data among 3 groups (P gt; 0.05). Results There were significant differences in operation time and blood loss among 3 groups (P lt; 0.05), and IF group was less than other 2 groups. All patients were followed up 1 year and 4 months to 2 years and 3 months with an average of 1 year and 8 months. In IF group, HA group, and THA group, the rates of early postoperative compl ications were 19.4% (6/31), 8.1% (3/37), and 7.5% (3/40), respectively; the rates of late postoperative compl ications were 29.0% (9/31), 13.5% (5/37), and 7.5% (3/40), respectively; and the reoperation rates were 29.0% (9/31), 10.8% (4/37), and 5.0% (2/40), respectively. The rates of the early postoperative compl ication, late postoperative compl ication, and reoperation rate were significantly higher in IF group than in HA group and THA group (P lt; 0.05), but there was no significant difference between HA group and THA group (P gt; 0.05). The mortal ity rates were 16.1% (5/31), 13.5% (5/37), and 15.0% (6/40) in IF group, HA group, and THA group, respectively; showing no significant difference (P gt; 0.05). According to Harris hip score, the excellent and good rates were 65.4% (17/26), 81.3% (26/32), and 85.3% (29/34) in IF group, HA group, and THA group, respectively; showing significant differences among 3 groups (P lt; 0.05). Conclusion According to patient’s age, l ife expectancy, and general conditions, THA is a reasonable choice for the patients aged 65-80 years with displaced femoral neck fracture.

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
  • EVALUATION ON CURATIVE EFFECT OF THREE OPERATIVE METHODS IN TREATMENT OF SENILE INTERTROCHANTERIC FRACTURE

    Objective To analyze the cl inical appl ication and effect of three operation methods in treatment of senile intertrochanteric fracture. Methods From July 2004 to February 2007, 73 patients with intertrochanteric fracture were treated. Of 73 patients, 33 patients were treated by artificial bipolar femoral head (ABFH group), 18 patients by dynamic hip screw (DHS group) and 22 by proximal femoral nail anti-rotation (PFNA group). In ABFH group, there were 19 males and 14 females with age of (72.5 ± 3.8) years. The injury was by tumbl ing in 19 cases, by accident traffic in 7 cases, fall ing from height in 4 cases and others in 3 cases, including 6 cases of type I, 9 cases of type II, 11 cases of type III and 7 cases of type IV accordingto Evans classification. The Harris hip score was 16.8 ± 4.8, and the disease course was (21.2 ± 7.8) hours. In DHS group, there were 10 males and 8 females with age of (69.5 ± 3.2) years. The injury was by tumbl ing in 11 cases, by accident traffic in 5 cases, fall ing from height in 1 case and other in 1 case, including 6 cases of type I, 3 cases of type II, 5 cases of type III and 4 cases of type IV according to Evans classification. The Harris hip score of was 18.6 ± 5.5, and the disease course was (19.8 ± 6.5) hours. In PFNA group, there were 13 males and 9 females with age of (70.3 ± 3.5) years. The injury was by tumbl ing in 11 cases, by accident traffic in 6 cases, fall ing from height in 3 cases and others in 2 cases, including 5 cases of type I, 6 cases of type II, 6 cases of type III and 5 cases of type IV according to Evans classification. The Harris hip score was 20.4 ± 6.6, and the disease course was (20.0 ± 5.8) hours. All fractures were fresh. There were no significant difference in general data between three groups (P gt; 0.05). Results In ABFH group, all incisions healed by first intention, but deep vein thrombosis occurred in 1 case on the postoperative third day. In DHS group, incisions healed by first intention in 16 cases and by second intention in 2 cases, coxa adducta occurred in 2 cases after operation. In PFNA group, all incisions healed by first intention. Cacothesis in pate occurred in 1 case after operation. There were significant differences in operation time, blood loss, and out-of-bed time (P lt; 0.05). The patients were followed up (30.5 ± 6.5) months in ABFH group, (27.6 ± 6.2) months in DHS group, and (24.8 ± 5.4) months inPFNA group. The union time of fracture was (7.5 ± 2.5) months in ABFH group, (8.4 ± 2.2) months in DHS group and (7.2 ± 2.4) months in PFNA group. There were significant differences in Harris score between before operation and after operation and between different time after operation in three groups (P lt; 0.05). Conculsion The three operative methods have some their superiority, but the replacement of artificial bipolar femoral head is more suitable for the senile unstable intertrochanteric fracture because of simply procedure, short operation time, less blood loss and early ambulation.

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • TREATMENT OF UNSTABLE FEMORAL INTERTROCHANTERIC FRACTURE IN ELDERLY PATIENTS WITH REBUILD SEPTUM BRONCHIALE IN ARTIFICIAL FEMORAL HEAD REPLACEMENT

    Objective To investigate the operative procedure and the therapeutic effects of unstable femoral intertrochanteric fracture in elderly patients with rebuild septum bronchiale in artificial femoral head replacement. Methods From October 2005 to October 2007, 113 elderly patients with unstable femoral intertrochanteric fracture were treated with artificial femoral head replacement with fixation of femoral greater trochanter and smaller trochanter in the help of bone cement in 58 cases (test group) and with γ-type bone nail in 55 cases (control group). In test group, there were 21 males and 37 females with an average age of 75 years, including 10 cases of type IIIA, 16 cases of type IIIB and 32 cases of type IV according to Evans-Jenson standard. In control group, there were 17 males and 38 females with an average age of 72.5 years,including 13 cases of type IIIA, 14 cases of type IIIB and 28 cases of type IV according to Evans-Jenson standard. All fractures were caused by fall damage. The disease course was 3 hours to 7.5 days (mean 1.4 days). The patients of two group compl icated with osteoporosis, and compl icated by one or several compl ications of coronary heart disease, hypertension, diabetes and chronic bronchitis. And all patients did not had fracture at other sites. There was no significant difference in general data between two groups (P gt; 0.05). Results The operations were successful, the incision healed by first intention. There were significant differences in operation time, operative blood loss and blood-transfusion between two groups (P lt; 0.05). The two group were followed 12-36 months. There were significant differences (P lt; 0.05) in the incidence rate of compl ication and the excellent and good rate of hip function (by Harris standard) between the test group (3.4% and 93.1%) and the control group (16.4% and 70.9%) 12 months after operation. Conclusion The aged patients with intertrochanteric fracture can get good result through caput femoris replacement, and rebuild septum bronchiale is of great significance.

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
  • TREATMENT OF INTERTROCHANTERIC COMMINUTED FRACTURE IN AGED PATIENTS BY REPLACEMENTOF ARTIFICIAL LONG-STEM BIPOLAR FEMORAL HEAD

    Agedness; Intertrochanteric fracture; Replacement of artificial femoral head

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • 人工股骨头置换治疗高龄股骨转子间骨折

    目的 总结人工股骨头置换治疗高龄复杂股骨转子间骨折的早期疗效。 方法 2003 年5 月-2007 年6 月,采用双动人工股骨头置换治疗高龄股骨转子间骨折36 例。男12 例,女24 例;年龄73 ~ 92 岁,平均83岁。均为跌倒后髋部着地所致骨折。骨折至手术时间3 ~ 20 d,平均8 d。按AO 分型,A1 型3 例,A2 型25 例,A3 型8 例。 结 果 36 例患者均安全渡过围手术期。获随访6 ~ 30 个月,平均18 个月。术后X线片示假体无松动、下沉及脱位,股骨近端无骨溶解或骨吸收,未发现异位骨化。随访末期Harris 评分75 ~ 93 分,平均91 分;术后评价优20 例,良12 例,可4 例,优良率88.9%。 结论 人工股骨头置换治疗高龄复杂股骨转子间骨折近期随访效果满意,但这一术式技术要求高,应严格掌握适应证。

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
  • 小切口后外侧入路人工股骨头置换术治疗老年股骨颈骨折

    【摘要】目的 总结采用小切口人工股骨头置换术治疗老年股骨颈骨折的临床疗效。方法 2007年7月-2008年11月,收治老年股骨颈骨折13例,男8例,女5例;年龄63~87岁,平均76岁。采用硬膜外阻滞麻醉12例,全麻1例;微创小切口以大粗隆顶点为标记,1/3在大转子近端,2/3在远端,行后外侧弧形切口长8~10 cm。均选用双极人工股骨头。采用骨水泥固定3例,无骨水泥固定10例。结果 术后无下肢深静脉血栓发生。13例平均随访6个月。Harris评分优8例,良3例,可1例,差1例,优良率为84.6%。结论 小切口后外侧入路人工股骨头置换术治疗老年股骨颈骨折,近期疗效较好。

    Release date:2016-09-08 09:31 Export PDF Favorites Scan
  • Comparison the Curative Effect of Two Modus Operandi for Treatment of Femoral Intertrochanteric Fracture to Elderly

    目的:比较人工股骨头置换与骨折内固定治疗高龄股骨转子间骨折的临床疗效。方法:筛选1997年6月至2008年6月间收治的60例高龄新鲜不稳定性股骨转子间骨折患者分为A、B两组。A组为行人工股骨头置换者,B组为行骨折内固定者。A组30例,平均年龄83.6岁;B组30例,平均年龄81.7岁。随访时间8个月~9年(平均2.3年)。结果:两种术式在住院时间和术后引流量的差异无统计学意义(Pgt;0.05);而在手术时间、术中出血量、下地开始行走时间、术后早期并发症、术后内科合并症和髋关节功能恢复、术后1年内死亡率等方面,两组比较差异均有统计学意义(Plt;0.05)。结论:人工股骨头置换术可以作为治疗高龄股骨转子间骨折的一种选择,术后能早期离床负重活动、较快恢复伤前活动能力、降低术后短期并发症和内科合并症的发生率、减低术后一年内死亡率。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • HEMIARTHROPLASTY COMBINED WITH GREATER TROCHANTER REATTACHMENT DEVICE FOR TREATING INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS

    ObjectiveTo evaluate the effectiveness of hemiarthroplasty combined with greater trochanter reattachment device for intertrochanteric fractures in elderly patients. MethodsA retrospective analysis was made on the clinical data of 34 patients (35 hips) with intertrochanteric fractures underwent hemiarthroplasty combined with greater trochanter reattachment device between February 2010 and April 2013.Of 34 patients,16 were males (16 hips) and 18 were females (19 hips),and the mean age was 85.6 years (range,77-95 years).All fractures were caused by falling.The left hip was involved in 20 cases,the right hip in 13 cases,and the bilateral hips in 1 case.There were 33 cases (34 hips) of fresh fracture,and 1 case (1 hip) of old fracture.Fractures were rated as type Ⅲ in 6 cases (6 hips),type IV in 11 cases (11 hips),and type V in 17 cases (18 hips) according to Evans-Jensen standard.All of the patients had different degree of osteoporosis and internal diseases. ResultsAll patients underwent surgery successfully.The operation time was 70-90 minutes (mean,76.6 minutes);the intraoperative blood loss was 260-400 mL (mean,301.5 mL);the postoperative drainage was 80-530 mL (mean,290.6 mL);and the hospitalization time was 10-12 days (mean,11.7 days).Postoperative infection of incision occurred in 1 case,which was cured after dressing;primary healing of incision was obtained in the other patients.No lower extremity deep vein thrombosis or other complications was observed.Twenty-six cases (27 hips) were followed up 12-48 months (mean,21.3 months).X-ray examination showed fracture healing,and the healing time was 2.5-3.5 months (mean,2.8 months).There was no dislocation,prosthesis loosening,dislocation,loosening of titanium cable,periprosthetic osteolysis,or other complications during the follow-up period.According to Harris hip score,the results were excellent in 8 hips,good in 15 hips,fair in 4 hips,and the excellent and good rate was 85.2% at 1 year after operation. ConclusionThe hemiarthroplasty combined with greater trochanter reattachment device is a feasible and effective method to treat intertrochanteric fractures in the elderly patients.It can allow early ambulation and improve quality of life,but it is necessary to strictly control the indications,and perioperative management should be paid attention.

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  • Efficacy comparison of different methods to treat femoral intertrochanteric fracture in aged patients

    ObjectiveTo compare the efficacy of proximal femoral nail anti-rotation (PFNA), locking compression plate (LCP), and artificial femoral head replacement for femoral intertrochanteric fracture in aged patients so as to provide reference for clinical treatment.MethodsA retrospective analysis was made on the clinical data of 150 aged patients with femoral intertrochanteric fracture treated between September 2009 and March 2016. PFNA was used in 51 cases (group A), LCP in 53 cases (group B), and artificial femoral head replacement in 46 cases (group C). There was no significant difference in sex, age, side, cause of injury, injury to operation time, type of fracture, and combined medical diseases between groups (P>0.05). The incision length, operation time, intraoperative blood loss, time for full weight bearing, hip Harris score, and complications were recorded and compared between groups.ResultsThe patients were followed up 12-23 months (mean, 18.6 months) in group A, 12-25 months (mean, 19.0 months) in group B, and 12-24 months (mean, 18.9 months) in group C. The incision length, operation time, and intraoperative blood loss of group A were significantly less than those of groups B and C (P<0.05); the operation time of group C was significantly shorter than that of group B (P<0.05), but there was no significant difference in incision length and intraoperative blood loss (P>0.05). The time for full weight bearing was significantly shorter in group C than groups A and B, and in group A than group B (P<0.05). Postoperative complications occurred in 11 patients of group A (21.6%), 14 patients of group B (26.4%), and 2 patients of group C (4.3%), showing significant difference between group C and group A or group B (P<0.05), but no significant difference was found between groups A and B (P>0.05). Hip Harris score at 12 months after operation had no significant difference between groups (P>0.05).ConclusionPFNA, LCP, and artificial femoral head replacement are all effective methods to treat femoral intertrochanteric fracture in aged patients. PFNA has the advantages of small incision, short operation time, less bleeding and simple procedure, and artificial femoral head replacement has the advantages of early time for full weight bearing, less bed rest time, and less complications. For these patients, PFNA and artificial femoral head replacement are appropriate.

    Release date:2017-06-15 10:04 Export PDF Favorites Scan
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