采用Wagner SL股骨柄假体半髋置换治疗高龄股骨转子间骨折的疗效观察.doc

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1、采用WagnerSL股骨柄假体半髓置换治疗高龄股骨转子间骨折的疗效观察［摘要］目的：探讨WagnerSL股骨柄治疗高龄股骨转子间骨折的方法。方法：2008年8月~2009年8月，采用WagnerSL股骨柄假体进行半髓置换术治疗股骨转子间骨折患者21例，男9例，女12例；按Jensen-Evans分型均为不稳定骨折。采用Singh分级评定骨质量均为骨质疏松。选择WagnerSL股骨柄假体进行半髓置换术。结果：平均部分负重时间为术后第3~5天，随访时间10~15个月,平均12个月，无失访病例。21例患者伤口均为一期愈合，术后及随访X线片假体位置好，均无明显疼痛

2、，无关节脱位和假体松动，无下肢深静脉血栓等，双下肢不等长6例，均在1cm以内。术后最后1次随访Harris评分优14例，良5例，可2例，优良率达90.5%0结论：WagnerSL股骨柄治疗股骨转子间骨折具有允许术后早期完全负重活动、降低并发症和功能恢复满意等优点，是治疗老年股骨转子间骨折合并骨质疏松较理想的手术方法。［关键词］WagnerSL；股骨转子间骨折；半髓置换；骨质疏松；高龄患者［中图分类号］R683.42［文献标识码］A［文章编号］1673-7210(2011)12(a)-023-04Clinicalobservationsoffemoralin

3、tertrochantericfractureinelderlypatientswithWagnerSLprostheticreplacementTONGGang,ZHAOJianfei,DAIJunDepartmentofOrthopaedics,CapitalMedicalUniversityAffiliatedtoBeijingTongrenHospital,Beijing100730,China［Abstract］Objective:Toexploretheclinicaloutcomeoffemoralintertrochantericfract

4、ureinelderlypatientstreatedbyWagnerSLprostheticreplacement.Methods:21elderlypatientsoffemoralintertrochantericfractureweretreatedwithWagnerSLprostheticreplacementfromAugust2008toAugust2009.Therewere9malesand12females・TheywereallunstablefracturesmeasuredbyJerisen-Evansclassificatio

5、n.ThequalityofthebonewasallosteoporosesratedbytheSinghindex・ThefracturesweretreatedwithWagnerSLprostheticreplacement.Results:Themeanpartialweight-bearingtimewasthethirdtofifthdayspostoperatively.Themeandurationoffollowupwas12months(10-15months),nolost.Thewoundhealingwassmoothinall

6、patients.TheprosthesesweregoodmeasuredbyX-ray.Therewasnopain,nodisloca廿onorloosenin已noDVT.Therewerebilateraldiscrepanciesofthelowerextremitiesin6cases,lessthan1cm.Therewereexcellentin14cases,goodin5casesandfairin2casesbasedontheHarrisscorepostoperative!y.Theoverallexcellentandgood

7、ratewas90.5%・Conclusion:WagnerSLprosthe廿creplacementcanprovideearlyfullweight-bearing,reducetheincideneeofpost-operativecomplicationsandgetsa廿sfactoryrehabilitaUon.Itisonekindofidealtreatmentforelderlypatientswithfemoralintertrochantericfractureandosteoporosis・[Keywords]WagnerSL;F

8、emoralintertrochantericfracture;P