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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Surgical treatment of unstable intertrochanteric fractures by bipolar hip replacement or total hip replacement in elderly osteoporotic patients
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Surgical treatment of unstable intertrochanteric fractures by bipolar hip replacement or total hip replacement in elderly osteoporotic patients

机译：双极髋关节置换术或全髋置换术治疗老年骨质疏松患者不稳定型股骨转子间骨折

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A retrospective study was conducted to assess the complications, clinical and functional outcomes at 5 years of follow-up of a series of elderly osteoporotic patients with an unstable intertrochanteric fracture treated by bipolar or total hip replacement. Fifty-four patients with an A2 intertrochanteric osteoporotic fracture were identified between 1996 and 2000. The average age of the patients was 81 years (SD=5). The follow-up time was 5 years. Patients received a bipolar or total hip replacement. During follow-up, we analyzed postoperative complications, mortality rate, functional results using the Harris hip score, time to return to normal activities, and radiographic evidence of healing. One patient died intraoperatively; two patients died on the third and eighth postoperative days and seven patients died within 1 year. Twenty-five patients were living at the 5-year follow-up. Harris hip score at 1 month was 64±8 (mean±SD); at 3 months, 75±5; at 1 year, 76±5; and at 5 years, 76±9. Weight-bearing was permitted immediately after surgery, as tolerated. Time to return to normal daily activities was 27±5 days. No loosening or infection of the implants were observed. In elderly osteoporotic patients with an unstable intertrochanteric fracture, bipolar or total hip replacement in association with reduction of the greater trochanter is a valid alternative to the standard treatment of internal fixation. This surgical technique permits a more rapid recovery with immediate weight-bearing, and a maintenance of a good level of function, with little risk of mechanical failure.
机译：进行了一项回顾性研究，以评估通过双极或全髋置换治疗的一系列不稳定型转子间骨折的老年骨质疏松患者在随访5年后的并发症，临床和功能结局。在1996年至2000年之间确定了54例A2股骨转子间骨质疏松性骨折患者。患者平均年龄为81岁（SD = 5）。随访时间为5年。患者接受了双极或全髋关节置换术。在随访期间，我们分析了术后并发症，死亡率，使用Harris髋关节评分的功能结果，恢复正常活动的时间以及放射学上的愈合证据。 1例患者在术中死亡。术后第三天和第八天有2例患者死亡，一年内有7例患者死亡。 25名患者在5年的随访中生活。 1个月时Harris髋关节评分为64±8（平均值±SD）; 3个月时为75±5; 1年时为76±5; 5年后为76±9。耐受后，允许在手术后立即承重。恢复正常日常活动的时间为27±5天。没有观察到植入物的松动或感染。对于不稳定的股骨转子间骨折的老年骨质疏松患者，双极或全髋关节置换术与大转子复位手术相结合是替代标准内固定术的有效选择。这种外科手术技术可以使患者更快地康复，并且可以立即负重，并且可以保持良好的功能水平，而机械故障的风险很小。

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