关键词 骨折，股骨粗隆间；人工关节；外科手术；老年人

    摘要 目的 分析及评价应用双动人工股骨头置换治疗高龄老年人不稳定股骨粗隆间骨折的方法及疗效。方法 应用人工双动股骨头治疗80岁以上股骨粗隆间骨折16例，男10例，女6例，年龄81~97岁，平均84.0岁。骨折类型按Evans分类：Ⅲ型4例，Ⅳ型10例，Ⅴ型2例。结果 术后3~20d下床，平均8d；住院时间16~28d，平均23d。16例患者随访0.5~3.0年(以髋关节活动度、疼痛程度及生活自理情况等为观察指标)，优良率为87.5%。无一例死亡，未出现假体松动、下沉等现象。结论 人工假体置换手术是高龄股骨粗隆间骨折治疗方法之一，近期疗效满意，但远期效果仍需继续观察。

    PROSTHETIC REPLACEMENT FOR MANAGEMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES IN 16 ELDER CASES

    Fan Jianwen,Dong Weiqiang,Cai Yongli.

    Department of Orthopaedics, Dashi Hospital of Panyu, Guangzhou 511430,China

    Key words bone fracture; intertrochanteric fractures; joint prosthesis; surgery; elder

    Abstract Objective To study the effect of prosthetic replacement on the management of unstable infertrochanteric fractures in the elders. Methods A retrospective analysis of 16 elder cases with prosthetic replacement for unstable intertrochanteric fracture was performed. The average age of 16 cases was 84.0 years old (ranged from 81 to 97 years old). Type Ⅲ of fracture by Evans classification was found in 4 cases, type Ⅳ in 10 cases, type Ⅴ in 2 cases. Results The mean time from operation to walking was 8 days. Followed-up period ranged from 6 months to 4 years. 14 of 16 cases had satisfactory effect. Conclusion Prosthetic replacement for the management of unstable intertrochanteric fractures in the elders is desirable. But the long-term effects are still doubt. ......