保留股骨距的骨水泥型双动半髋人工关节置换治疗高龄转子间骨折

目的：探讨高龄转子间骨折行双动人工关节置换的手术适应症及手术方法。方法：对16例老年转子间骨折采取人工双动半髋关节置换术，男9例，女7例，年龄67-91岁，平均76．5岁。骨折分类按Evans分型，EvansⅠ型12例，EvansⅡ型4例，手术过程中保留股骨距，大转子行改良张力带钢丝固定后，行分次骨水泥双动人工关节置换。结果：手术时间最短52分钟-72分钟，平均68分钟；术中出血210ml-400ml，平均326ml；术后6月手术疗效评价按Harris评分，76分-93分，平均78．5分，无严重并发症发生。术后随访6～22个月，平均18．4月，随访期间未见假体松动及髋臼磨损。结论：以双动人工关节置换治疗高龄转子间骨折是一种较为有效、可行的方法；合适的手术适应症选择及正确的假体选择和手术操作是其关键。

Cemented bipolar hemiarthroplasties with retain calcar for intertrochanteric fracture in the senile

Objective:To investigate the clinical indication and effectiveness technique for intertrochanteric frature(and intertrochanteric frature nonuion) in senile.Methods:Sixteen cases of intertrochanteric frature were treated by cemented bipolar hemiarthroplasties. All the patients included 9 males and 7 females, and the average age was 76.5 years(range from 67 to 91 years).Fractured fragments of greater trochanter and less trochanter were preserved during the operation, and with reform tension-band wires to fix the greater trochanter and less trochanter fracture fragments. Applied cement by apart for bipolar hemiarthroplasties.Results:The average operation time was 68 minutes (range from 52 to 72 minutes),and the average blood loss during the operating was 326ml(range from 210ml to 400ml).Harris score system was 78.6 points(range from 76 to 83 points). The follow-up was ranged from 6 to 22 months(average 18.4 months).there was no severe complications related to the prosthesis loosening and acetabular wear during the follow-up.Conclusion: Bipolar hemiarthroplasties is a feasible and an effective procedure in the treatment of intertrochanteric fracture in senile. The choice of appropriate indications and prosthesis as well as the opetative technique is crucial to success.