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Clinical outcome of endoprosthetic replacement for failed treatment of intertrochanteric fractures: A retrospective case series

机译:股骨粗隆间骨折治疗失败的假体置换的临床结果:回顾性病例系列

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摘要

>Objective: The treatment methods for the failed internal fixation in elderly patients suffering from several osteoporostic fractures are still inconclusive. We aimed to evaluate the clinical effects of endoprosthetic replacement for failure treatment of intertrochanteric fracture. >Methodology: A total of 13 patients with failed internal fixation for intertrochanteric fracture were collected between January 2002 and October 2009. All of them were treated with endoprosthetic replacement and followed up till October 2010. Four of them received total hip replacement and the remained nine received artificial bipolar femoral head replacement. Clinical and functional outcomes of patients were assessed. >Results: Of 13 patients, nine were females and four were males with the mean age of 76.5 years (SD, 11.7, range, 58-92 years) at the time of fracture. The average time of operation and follow-up was 124 minutes (89-187minutes) and 31 months (14-68 months), respectively. The average blood loss during the operation was 631 ml (450-1560 ml). All patients showed good pain relief and functional improvement. Final post-operative Harris and WOMAC scores were significantly improved from pre-operative levels (P<0.05). Only five patients showed operative complications. >Conclusions: Our finding indicated that endoprosthetic replacement is an effective salvage procedure for failed internal fixation of intertrochanteric fracture in elderly patients with effective pain relief and functional improvement as well as few serious complications.
机译:>目的:对于患有数例骨质疏松性骨折的老年患者,内固定失败的治疗方法尚无定论。我们旨在评估人工关节置换治疗股骨转子间骨折失败的临床效果。 >方法:在2002年1月至2009年10月期间,共收集了13例因股骨转子间骨折内固定失败的患者。所有患者均接受了人工修复,并随访至2010年10月。其中4例接受了手术。进行髋关节置换,其余九例接受人工双极股骨头置换。评估患者的临床和功能结局。 >结果:在13例患者中,骨折时的平均年龄为76.5岁(SD,11.7,范围为58-92岁),其中女性为9位,男性为4位。平均手术时间和随访时间分别为124分钟(89-187分钟)和31个月(14-68个月)。手术期间的平均失血量为631毫升(450-1560毫升)。所有患者均表现出良好的疼痛缓解和功能改善。最终的术后Harris和WOMAC评分较术前水平有显着改善(P <0.05)。仅五名患者表现出手术并发症。 >结论:我们的发现表明,对于年长的转子粗隆间骨折内固定失败,有效缓解疼痛和功能改善且很少出现严重并发症的患者,假体置换术是一种有效的抢救方法。

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