生物型加长柄髋关节置换对高龄不稳定股骨转子间骨折围术期指标及术后恢复的影响

doi:10.3969/j.issn.1006-6233.2021.07.019

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Abstract Objective: To study the effects of biotype long-stem hip replacement on perioperative indicators and postoperative recovery of elderly unstable intertrochanteric fractures. Methods: 248 patients with unstable intertrochanteric fractures treated in our hospital from April 2014 to April 2019 were selected and divided into two groups by simple random grouping, with 124 cases in each group. They were given bioprosthesis and bone cement prosthesis under intravenous inhalation general anesthesia or continuous epidural anesthesia respectively to perform hemi-hip replacement therapy. The perioperative indicators, prosthetic stability, postoperative hip function and complications were compared between the two groups. Results: The operative time and first ambulation time in biotype group were significantly lower than those in bone cement group (P<0.05), and there were no statistically significant differences in the intraoperative blood loss and hospital stay between the two groups (P>0.05). The prosthesis sinking distance in biotype group was significantly lower than that in bone cement group (P<0.05), and the incidence rates of prosthesis loosening in the two groups were 3.23% and 4.84% respectively (P>0.05). The Harris scores were significantly increased in the two groups (P<0.05), and the Harris scores at 1, 3, 6 and 12 months after surgery in biotype group were higher than those in bone cement group (P<0.05). The recovery effect of hip function in biotype group at 12 months after surgery was obviously better than that in bone cement group (P<0.05), and the excellent and good rates in the two groups were 72.58% and 54.84% (P<0.05). The incidence rates of postoperative infection and bone cement poisoning in biotype group were significantly lower than those in bone cement group (P<0.05), and the incidence rates of postoperative complications in the two groups were 11.29% and 28.23% (P<0.05), and the case fatality rates were 3.23% and 4.84% respectively(P>0.05). Conclusion: Biotype long-stem hip replacement for elderly patients with unstable intertrochanteric fractures is beneficial to shorten the operative time, promote postoperative rehabilitation, improve the stability of prosthesis and the recovery effect of hip function, and reduce the risk of postoperative complications.

Key words： Intertrochanteric fractures Elderly Hip replacement Biotype Perioperative indicators

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.07.019 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I7/1147

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