Abstract: 【Abstract】〓Objective〓To discuss surgical techniques of unstable intertrochanteric fracture in the advanced age with hip hemiarthroplasty. Methods〓Sixty-four cases of hemiarthroplasty in aged (more than 75 years old) unstable intertrochanteric fractures were retrospectively analyzed. The operative time, the time beginning to walk after operation, postoperative pain, postoperative functional recovery and the complications were analyzed. Results〓The average time of operation was 75 minutes,mean intraoperative blood loss was 360 ml,the average time beginning to walk after operation was 6 days. The patients were followed up for six months to 4 years. According to the Harris hip scoring system (pain 44 points, function 47 points, deformity 4 points, joint activity 5 points) assessment, excellent rate was 84.5%. No postoperative infection, loosening of fixation and prosthesis sinking phenomenon were found in all cases. Conclusion〓Hemiarthroplasty is an effective way of intertrochanteric fracture in the advanced age and helps patients resume earlier.

Key words: Advanced age, Unstable intertrochanteric fracture, Hemiarthroplasty, Surgical experience

摘要： 【摘要】〓目的〓探讨高龄股骨粗隆间不稳定骨折人工股骨头置换的手术技巧,以缩短手术时间,提高手术质量。方法〓从手术时间、术后下床时间、术后疼痛、术后功能恢复及有无并发症方面,对64例进行人工股骨头置换的高龄股骨粗隆间不稳定的骨折手术进行回顾性分析、总结。结果〓手术平均时间75分钟,术中平均出血量为360 mL,术后平均下床时间6天,经过6个月~4年随访,按髋关节Harris评分系统(疼痛44分,功能47分,畸形4分,关节活动5分)评定,优良率为84.5%,术后未见有感染、松动、下沉的现象。结论〓人工股骨头置换是治疗高龄股骨粗隆间不稳定骨折有效的方法,熟练的掌握其手术技巧,可以早期恢复关节功能,提高患者生活质量。

关键词: 高龄, 股骨粗隆间不稳定骨折, 人工股骨头置换, 手术体会