人工股骨头置换治疗高龄不稳定股骨粗隆间骨折的临床研究
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摘要
目的：通过人工股骨头置换与切开复位内固定治疗高龄不稳定股骨粗隆间骨折的疗效对比,探讨人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折的适应症及方法。方法：本研究将自山东中医药大学附属医院骨科病房2003年2月至2009年6月收治的高龄不稳定股骨粗隆间骨折病例中选出的符合本研究标准的病例85例,分为切开复位内固定组(59例)与人工股骨头置换组(26例)两组,通过病历回顾和术后随访,对两组的年龄、术前Evans分型、术前主要合并病、手术时间、术中出血量、术后并发症、住院时间、下地时间、内固定或假体的松动(失效)率、下地后1月及半年的Harris评分进行对比。结果：人工股骨头置换组下地时间早,可以明显降低术后下肢深静脉血栓形成的发生率,下地1月后患髋Harris评分在均数及优良率方面优于切开复位内固定组,下地半年后Harris功能评分在均数方面与切开复位内固定组无差别,但优良率达到92.3%明显优于切开复位内固定组。结论：人工股骨头置换术可大大减少卧床时间,减少术后卧床并发症的发生,可使患髋在短期内恢复至伤前水平,因此人工股骨头置换术是治疗高龄不稳定股骨粗隆间骨折的合理选择。
Objective:To study the indications and surgical procedure of hemiarthroplasty for elderly patients with unstable intertrochanteric femoral fractures. Through Comparative efficacy of hemiarthroplasty and fixation for elderly patients with unstable intertrochan-teric femoral fractures. Methods:In this study,85 cases of elderly patients with unstable intertrochanteric femoral fractures were chose from Affiliated Hospital of Shandong University of TCM orthopedics ward from February 2003 to June 2009 in line with the standard of this study,85 cases were divided into the fixation group (59 cases) and hemiarthroplasty group (26 cases), through chart review and postoperative follow-up, compared two groups in age, preoperative Evans classification, the main incidence of preoperative, operative time, blood loss, hospitalization time, Shimoji time, postoperative complications, internal fixation or prosthetic loosening (failure) rate, Harris score of 1 month and six month after Shimoji.Result:Hemiarthroplasty group earlier than fixation group in shimoji time, can significantly reduce the incidence of postoperative deep venous thrombosis. Harris score of 1 month after Shimoji in both the number and excellent rate is superior to internal fixation group, Harris score of six month after Shimoji in the number is non-discrimination with the internal fixation group, but the excellent rate of 92.3% is better than internal fixation group. Conclusion:Hemiarthroplasty can significantly reduce the bed time, reduce the incidence of postoperative complications in bed suffering, Short-term restored to pre-injury level in ipsilateral hip joint. So hemiarthroplasty is the reasonable choice in treatment of elderly patients with unstable intertrochanteric femoral fractures.
Objective:To study the indications and surgical procedure of hemiarthroplasty for elderly patients with unstable intertrochanteric femoral fractures. Through Comparative efficacy of hemiarthroplasty and fixation for elderly patients with unstable intertrochan-teric femoral fractures. Methods:In this study,85 cases of elderly patients with unstable intertrochanteric femoral fractures were chose from Affiliated Hospital of Shandong University of TCM orthopedics ward from February 2003 to June 2009 in line with the standard of this study,85 cases were divided into the fixation group (59 cases) and hemiarthroplasty group (26 cases), through chart review and postoperative follow-up, compared two groups in age, preoperative Evans classification, the main incidence of preoperative, operative time, blood loss, hospitalization time, Shimoji time, postoperative complications, internal fixation or prosthetic loosening (failure) rate, Harris score of 1 month and six month after Shimoji.Result:Hemiarthroplasty group earlier than fixation group in shimoji time, can significantly reduce the incidence of postoperative deep venous thrombosis. Harris score of 1 month after Shimoji in both the number and excellent rate is superior to internal fixation group, Harris score of six month after Shimoji in the number is non-discrimination with the internal fixation group, but the excellent rate of 92.3% is better than internal fixation group. Conclusion:Hemiarthroplasty can significantly reduce the bed time, reduce the incidence of postoperative complications in bed suffering, Short-term restored to pre-injury level in ipsilateral hip joint. So hemiarthroplasty is the reasonable choice in treatment of elderly patients with unstable intertrochanteric femoral fractures.
引文
[1]Evans EM. The treatment of trochanteric fracture of the femur[J]. J Bone Joint Surg (Br),1949;31:190-193.
[2]Masud-Jawed-S, Doyle-DW, etal. A Population study of thgscreening potential of assessment of trabeeular Pattern of the femoral neek (Sing index):the Chingofrd Study. Br-J-Radiol,1995APr,68 (808):389-393.
[3]Harty M. The ealear femorale and the femoral. J Bone Joint Surg 1957; 39:62 5.
[4]Hollinshead WH. Anatomy for surgeons. volume 3, the back and limbs. New York, San Francisco, London:Harper & Row Publishers,1969:649.
[5]Kenzora, Mc Carthy KE. Lowell JD, etal. Hipfiacturemortality:relation to age, treatment, Preoperative illness time of surgery, and complicatio-n,clinorthop,1984;86:45-56.
[6]程立明,李健.80岁以上高龄髋部骨折的手术治疗临床分析(附85例)[J].骨与关节损伤杂志,2002：17(5)：379-381.
[7]Larsson S, Friberg S, Hansson LT. Trochanteric fracture:influence of reduction and implant position on impaction and complication. Clin Orthop,1990:259:130-139.
[8]朱通伯,戴尅戎.骨科手术学[M].第2版.北京：人民卫生出版社,1999：331-332.
[9]赵昌平,冯和林,李增炎等.Gamma钉治疗70岁以上老年粗隆间骨折[J].实用骨科杂志,2005：5：449-450.
[10]陈立,麦庆春.单臂多功能外固定支架治疗老年股骨粗隆间骨折[J].按摩与导引,2006：22：35-36.
[11]Tronzo RG. The use of an endoprosthesis for severely comminuted rochan-teric fractures[J]. Orthop Clin North Am,1974;5(4):679-681.
[12]Green S, Moore T, Proano F. Bipolar prosthetic replacement for the manageme-nt of unstable intertrochanteric hip fractures in the elderly [J]. Clin Orthop Relat Res,1987; (224):169-177.
[13]Osman Podop, Ahmet Kiral,Halud Kaplan, et al. Primary bipolar hemipros-thesisfor unstable intertrochanteric fractures [J]. Intemational Orthop-aedics(SICOT),2002;26:233-237.
[14]彭菁,陈力,陈钢等.腹部外科手术出血量的观察和评估,护士进修杂志,2002;7(7)：499-501.
[15]徐斌.人工髋关节置换与下肢深静脉血栓形成[J].中国关节外科杂,2004;3(12)318.
[16]Chan KC, GillGS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res 2000:317:206-215.
[17]Gebhard JS, Amstutz HC, Zinar DM, et al.A comparison of total hip arthroplasty and hemiarthroplasty for treatment of actue fracture of the femoral neck[J].Clin Orthop,1992;(282):123-131.
[18]梁雨田,唐佩福,郭义柱等.高龄患者非稳定性股骨粗隆间骨折人工股骨头置换临床研究[J].中华医学杂志,2005;85(46)：3260-3261.
[19]曹成福,纪斌,谢林等.长柄人工股骨头置换治疗老年骨质疏松粉碎性股骨粗隆间骨折的临床研究[J].骨与关节损伤杂志,2004：19.
[20]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[21]毕海勇,张树栋等.人工关节置换术治疗高龄股骨粗隆间骨折[J].实用骨科杂志.2003：9(4)：300-301.
[22]毛宾尧.人工髋关节外科学.人民卫生出版社.2002;第一版：140-180.
[23]Morrey BF. Instability after total hip arthrophasty[J].clin Orth-op,1992;23:237-248.
[24]Smith-Petersen MN. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg (Am),1949;31:40.
[25]廉永云,Yoo Myungchul,裴福兴等.骨性强直的髋关节转换人工全髋关节置换术.中国骨与关节损伤杂志,2006;21(8)：23-24.
[26]王爱国.人工关节置换在不稳定股骨粗隆间骨折中的应用,医药论坛杂志,2005;26(11)：16-17.
[27]高雁卿,左立新等.高龄转子间骨折人工股骨头置换相关问题.临床骨科杂志.2004：7(1)：21-22.
[28]OtaniT, WhitesideLA, White SE. The effect of axial and torsional loading on strain distribution in the proximal femur as related to cementless total hip arthroplasty [J].Clin Orthop Res,1993;292:376-383.
[29]Motobe T,Hashiguchi T, Uchimura T.et al. Endogenous cannabinoids are candidates for lipid mediators of bone cement implantation syndrome. Shock,2004:21(1):8-12.
[30]Wadia F, Shah N,Porter M, Bilateral chamley low-friction arthroplasty with cement in a patient with phknodysostosis, A case report J Bone Joint Surg Am,2006;88(8):1846-1848.
[31]Ahmed Ⅱ,Abadir A, Spontaneous IOL-CTR dislocation. J Cataract Refract Surg,2007; 33 (2):176.
[32]刘玉杰,卢世璧,刘保卫等.人工髋关节置换术并发股骨骨折临床分析.中华外科杂志,1998：36(2)：93-95.
[33]卢世壁,王继芳,王岩等主译.坎贝尔骨科手术学.第10版.济南：山东科学技术出版社,2005：329.
[34]吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3)：155.
[35]Hull RD, Raskob GE. Prophylaxis of venous thromboembolic disease follo-wing hip and knee surgery. J Bone Joint Surg[Am] 1986;68-A:146-150.
[36]王晓,刘洋,张世清.下肢损伤并发急性肺动脉栓塞四例[J].骨与关节损伤杂志,2000：15(2)：153.
[37]吴庆华.急性下肢深静脉血栓的溶栓抗凝治疗[J].中国志,2003;23(4)：202-205.
[38]杨刚,吕厚山等.低分子肝素预防人工髋、膝关节置换术后下肢深静脉血栓形的研究.中华外科杂志.2000;1(38)：25-27.
[39]Lee CH, Hankey GJ,Ho WK, et al.Venousthromboembolism:diagnosis and management of deep venous thrombosis [J]. Med J Aust,2005; 182 (9):476-481.
[40]Khan A, et al. Dislocation following total hip preplacement. J Bone Joint Surg,1981;63B:214.
[41]Pierchon F, Pasquier G, Cotton A, et al. Causes of dislocation of total hip arthroplasty JBJS,1994;76:45-49.
[42]Buohhot ZHW, Ilson RA,Lodenkanper H. Management of dleep infections of total hip replacement[J].J Bone Jiont Surg,1981;6313(4):342.
[43]龙树明,吴术红,刘毅等.人工股骨头置换治疗老年不稳定性股骨粗隆间骨折[J].实用临床医学,2006：7(4)：57.
[1]俞强,林欣.股骨粗隆间骨折的治疗.河北医学,Apr 2004;10(4)：376-378.
[2]王亦璁.骨与关节损伤[M].第3版.北京：人民卫生出版社,2001：865-871.
[3]洪云飞,康智,王琦等.老年人股骨粗隆间骨折内固定手术术前评估及术后并发症原因分析[J].中原医刊,2006;33(5)：13.
[4]Davidson CW, Merrilees MJ, Wilkinson TJ, et al. Hip fracture mortality and morbidity can we do better? N Z Med J,2001,114(1136):329.
[5]Larsson S, Friberg S, Hansson LT.Trochanteric fracture:influence of reduction and implant position on impaction and complication. Clin Orthop,1990;259:130-139.
[6]朱江涛,卫晓春.股骨粗隆间骨折分型.实用骨科杂志.2007;7：410.
[7]胥少汀等.实用骨科学.人民军医出版社.2005;第三版：709.
[8]Evans EM. The treatment of trochanteric fracture of the femur[J].J Bone Joint Surg(Br),1949;31:190-193.
[9]Jensen JS, Tondevold E, Sonne-Holm S. Stable trochanteric fractures, A comp-arative analysis of four methods of internal fixation[J]. Acta Orthop Scand,1980;51(5):811-816.
[10]Mullerler ME, Nazarian S, Koch P. The Comprehensive Classification of Frac-tures of the Long Bones. New York:Springer-Verlag,1990:118.
[11]李亚东,刘长贵,王宝军等.老年人股骨粗隆间骨折骨牵引治疗的临床分析[J].中国临床医生,2005;5：30-32.
[12]王亦璁,主编.骨与关节损伤[M].第4版,北京：人民卫生出版社,2007：1184-1191.
[13]危杰.股骨转子间骨折[J].中华创伤骨科杂志,2004;5：554-557.
[14]Lindskog DM, Bnamgaertner MR. Unstable intertroehantefic hip fractures in the eldly[J].Am Acad Orthop Surg,2004;12:179-190.
[15]Parker MJ, Handoll HH. Extramedullary fixation implants and external fix-atorns for extracapsular hip fractures[J]. Cochrane Database SystRev, 2002;2:CD000339.
[16]陈立,麦庆春.单臂多功能外固定支架治疗老年股骨粗隆间骨折[J].按摩与导引,2006：22：35-36.
[17]Wolfang GL, Bryant MH, O'Neill JP. Treatment of intertroehanteric fracture of the femur using sliding serew plate fixation. Clin Orthop,1982;163: 148.
[18]闰洪印,陈楠.股骨粗隆间骨折早期内固定的手术治疗选择[J].骨与关节损伤杂志,2002：17：148.
[19]张伯松等,股骨转子间骨折与股骨颈骨折内固定失败后行人工髋关节置换术后比较[J].中华创伤骨科杂志,2002：4(3)：202-205.
[20]袁宏等.95°髁钢板与Richards钉治疗老年转子间骨折.骨与关节损伤,2000;15(4)：305-306.
[21]KrettekC. Fbrword:concepts of minimally invasive plateosteosynthesis [J]. Injury,1997;28(Suppl):Al-2.
[22]Krettek C, Schandelmaier P, Miclau T, et al. Transarticular jiont reconst-ruction and indirect plate synthesis for complex distal supracondylar femoral fracture [J]. Injury,1997;28(Suppl):A31-41.
[23]Kregor PJ. Introdution[J], Injury,2001;32(Suppl):C1-2.
[24]张俊杰等,股骨远端LISS钢板倒置治疗复杂股骨粗隆间骨折[J].中国骨与关节损伤杂,2009：4：334-335.
[25]Levy RN. Siegel M. Sedlin ED. et al. Compli eat ions of Ender pin fixation basi-cervical, in tertroehanteric and subtroehanteric fractures of the hip. J Bone Joint Surg(Am),1953;65:66.
[26]Gurtler RA, Jaeobs RR, Jaeobs CR. Biomeehanical evaluation of the Ender's pin, the harris nail and the dynamic hips screw for the unstable intertr-oehanteric fracture. Clin Orthop,1986;206:109.
[27]Lautenschalger EP, Uonaghan P. Titanium nad titanium alloys asdental maeri-als[J].Jint Dent,2004;43:245-248.
[28]Haynes RC, Poll RG,Miles AW.Et al.Failure of femoral head fixation:a cadaveric of lag screw cutout with the Gamma locking nail and AO dynamic hip Screw[J].Injury,1997:28:337-341.
[29]赵昌平,冯和林,李增炎等.Gamma钉治疗70岁以上老年粗隆间骨折[J].实用骨科杂志,2005：5：449-450.
[30]Gotze B, Bormiare F, Weisc K, etal. Belashtahrkeit yon osetesynthesen beiin-stabilen perund subtrochanteren femudrakturen[J]. Ak. tuelle Trammato-l,1998;28:197-204.
[31]James P, Waddell, Jnae Morton, et al. The role of total hip replacement in interchnateric fractuers of the femur [J]. Clinical Orthop and Related Research,2004;429:49-53.
[32]Rodop 0, Kiral A, Kaplan H, et al. Primary bipolar he miprosthe sis for unstable intertrochanteric fracture. Int Orthop,2002;6:233.
[33]Broos PL, Rommens PM, Greens VR, et al. Pertrochanteric fractures in the elderly. Is the Belgian VDP prosthesis the best treatment for unstable fractures with severe comminution Acta Chir Belg,1991;91:242.
[34]纪方,朴润秀,蔡郑东等.人工假体置换治疗高龄老年人不稳定粗隆间骨[J].骨与关节损伤杂志,2002：9：184-185.
[35]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[36]尤佳,姜文学等.人工双极股骨头置换治疗老年股骨粗隆间不稳定骨折.中国骨与关节损伤杂志,2006;21(8)：637.
[37]Cases CK,Gurder S, Gill. Cemented hemiarthroplasties for elderly pa-tients with intertrochanteris fractures[J].Clin Ortho,2000;2:206-215.
[38]朱天岳.不应将人工股骨头置换的适应证扩大到股骨粗隆间骨折[J].临床骨科杂志.2004：1：78.
[39]毛宾尧,陆勇等.人工股骨头置换治疗高龄股骨转子间骨折,中华创伤骨科杂志.2004：6(9)：1053-1055.
[40]Rodop O,Kiral A. Primary bipolar hemiprosthesis for unstable intertro-chanteric fractures. Int Orthop,2002;26(41):233-237.
[41]Kesemenli C, Subasi M, Arslan H. Treatment of intertroehanteric fractures in elderly patients with Leinbach type endoprosthesis.Ulus Trauma Derg,2001;7(4):254-254.
[42]Haentjens, P;Lamraski, G.Endoprosthetic replacement of unstable, comminu-ted intertrochanteric fracture of the femur in the elderly, osteopor-otic patient.Disabil Rehabil.2005 Sep 30 Octl5;27(18-19):1167-80.
[43]高雁卿,左立新等.高龄转子间骨折人工股骨头置换相关问题.临床骨科志.2004;7(1)：21-22.
[44]韩小松,向柄彦,邓江等.人工关节置换治疗高龄股骨粗隆间骨折,现代医药卫生.2007：23(19)：2867-2868.
[45]张国鑫,谷长跃,李延明等.人工全髋关节置换翻修术术前假体松动的回顾性研究[J].中国骨与关节损伤,2007;21(12)：831-833.
[46]裴福兴,邱贵兴.关节外科聚焦[M].北京：人民军医出版社,2007：252-256.
[47]Jasty M, Maloney WJ, Bragdon CR etal. The initiation of failure in cemented femoral components of hip arthroplasties [J]. J Bone Jiont Surg Br,1991; 73(4):551-558.
[48]Delee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement[J].Clin Orthop,1976;121:20-32.
[49]Gruen TA, Mcniece GM, Amstutz HC.'Modes of failure'of cemented stemtype femoral component:a radiographic analysis of loosening [J]. Clin Orthop, 1979:141:17-27.
[50]Duncan CP, MasriBA. Fractures of the femur after hip replacement. Instr-Course Lect,1995:44:293-304.
[51]张炅等,股骨假体周围骨折手术治疗策略.中华关节外科杂志.2009;10(5)：558-565.
[52]管东辉,LISS接骨板治疗假体稳定型全款关节置换术后股骨假体周围骨折8例报告.山东医药.2009：49(2)：41.
[53]龙浩等,人工股骨头置换术后股骨头脱位的原因分析.中华关节外科杂志.2009;8(4)：463-470.
[54]朱通伯,戴尅戎.骨科手术学.北京.人民卫生出版社,1998;2版：636.
[55]刘明轩,曹成福,张启宽等.长柄人工髋关节置换治疗高龄股骨转子间骨折的实验及临床研究.骨与关节损伤杂志,2003;18(7)：444-446.
[56]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[57]卢晓栋等,股骨矩替代型人工关节治疗股骨转子间骨折21例分析.天津医药.2009：37(4)：319-321.
[58]BalBS, MaurerBT, HarrisWH. Trochantericunion following revision total hip arthroplasty[J].JArthroplasty,1998;13:29-33.
[59]黄小强,带大粗隆柄人工关节置换治疗高龄股骨粗隆间骨折76例.第四军医大学学报,2006：27(5)：450.
[60]杜建层等.他汀类药物防治骨质疏松症[J].中国骨质疏松志,2004;10(1)：109.
[61]廖二元,谭利华.代谢性骨病学[M].北京：人民卫生出版社,2003：630-716.
[2]Masud-Jawed-S, Doyle-DW, etal. A Population study of thgscreening potential of assessment of trabeeular Pattern of the femoral neek (Sing index):the Chingofrd Study. Br-J-Radiol,1995APr,68 (808):389-393.
[3]Harty M. The ealear femorale and the femoral. J Bone Joint Surg 1957; 39:62 5.
[4]Hollinshead WH. Anatomy for surgeons. volume 3, the back and limbs. New York, San Francisco, London:Harper & Row Publishers,1969:649.
[5]Kenzora, Mc Carthy KE. Lowell JD, etal. Hipfiacturemortality:relation to age, treatment, Preoperative illness time of surgery, and complicatio-n,clinorthop,1984;86:45-56.
[6]程立明,李健.80岁以上高龄髋部骨折的手术治疗临床分析(附85例)[J].骨与关节损伤杂志,2002：17(5)：379-381.
[7]Larsson S, Friberg S, Hansson LT. Trochanteric fracture:influence of reduction and implant position on impaction and complication. Clin Orthop,1990:259:130-139.
[8]朱通伯,戴尅戎.骨科手术学[M].第2版.北京：人民卫生出版社,1999：331-332.
[9]赵昌平,冯和林,李增炎等.Gamma钉治疗70岁以上老年粗隆间骨折[J].实用骨科杂志,2005：5：449-450.
[10]陈立,麦庆春.单臂多功能外固定支架治疗老年股骨粗隆间骨折[J].按摩与导引,2006：22：35-36.
[11]Tronzo RG. The use of an endoprosthesis for severely comminuted rochan-teric fractures[J]. Orthop Clin North Am,1974;5(4):679-681.
[12]Green S, Moore T, Proano F. Bipolar prosthetic replacement for the manageme-nt of unstable intertrochanteric hip fractures in the elderly [J]. Clin Orthop Relat Res,1987; (224):169-177.
[13]Osman Podop, Ahmet Kiral,Halud Kaplan, et al. Primary bipolar hemipros-thesisfor unstable intertrochanteric fractures [J]. Intemational Orthop-aedics(SICOT),2002;26:233-237.
[14]彭菁,陈力,陈钢等.腹部外科手术出血量的观察和评估,护士进修杂志,2002;7(7)：499-501.
[15]徐斌.人工髋关节置换与下肢深静脉血栓形成[J].中国关节外科杂,2004;3(12)318.
[16]Chan KC, GillGS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res 2000:317:206-215.
[17]Gebhard JS, Amstutz HC, Zinar DM, et al.A comparison of total hip arthroplasty and hemiarthroplasty for treatment of actue fracture of the femoral neck[J].Clin Orthop,1992;(282):123-131.
[18]梁雨田,唐佩福,郭义柱等.高龄患者非稳定性股骨粗隆间骨折人工股骨头置换临床研究[J].中华医学杂志,2005;85(46)：3260-3261.
[19]曹成福,纪斌,谢林等.长柄人工股骨头置换治疗老年骨质疏松粉碎性股骨粗隆间骨折的临床研究[J].骨与关节损伤杂志,2004：19.
[20]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[21]毕海勇,张树栋等.人工关节置换术治疗高龄股骨粗隆间骨折[J].实用骨科杂志.2003：9(4)：300-301.
[22]毛宾尧.人工髋关节外科学.人民卫生出版社.2002;第一版：140-180.
[23]Morrey BF. Instability after total hip arthrophasty[J].clin Orth-op,1992;23:237-248.
[24]Smith-Petersen MN. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg (Am),1949;31:40.
[25]廉永云,Yoo Myungchul,裴福兴等.骨性强直的髋关节转换人工全髋关节置换术.中国骨与关节损伤杂志,2006;21(8)：23-24.
[26]王爱国.人工关节置换在不稳定股骨粗隆间骨折中的应用,医药论坛杂志,2005;26(11)：16-17.
[27]高雁卿,左立新等.高龄转子间骨折人工股骨头置换相关问题.临床骨科杂志.2004：7(1)：21-22.
[28]OtaniT, WhitesideLA, White SE. The effect of axial and torsional loading on strain distribution in the proximal femur as related to cementless total hip arthroplasty [J].Clin Orthop Res,1993;292:376-383.
[29]Motobe T,Hashiguchi T, Uchimura T.et al. Endogenous cannabinoids are candidates for lipid mediators of bone cement implantation syndrome. Shock,2004:21(1):8-12.
[30]Wadia F, Shah N,Porter M, Bilateral chamley low-friction arthroplasty with cement in a patient with phknodysostosis, A case report J Bone Joint Surg Am,2006;88(8):1846-1848.
[31]Ahmed Ⅱ,Abadir A, Spontaneous IOL-CTR dislocation. J Cataract Refract Surg,2007; 33 (2):176.
[32]刘玉杰,卢世璧,刘保卫等.人工髋关节置换术并发股骨骨折临床分析.中华外科杂志,1998：36(2)：93-95.
[33]卢世壁,王继芳,王岩等主译.坎贝尔骨科手术学.第10版.济南：山东科学技术出版社,2005：329.
[34]吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3)：155.
[35]Hull RD, Raskob GE. Prophylaxis of venous thromboembolic disease follo-wing hip and knee surgery. J Bone Joint Surg[Am] 1986;68-A:146-150.
[36]王晓,刘洋,张世清.下肢损伤并发急性肺动脉栓塞四例[J].骨与关节损伤杂志,2000：15(2)：153.
[37]吴庆华.急性下肢深静脉血栓的溶栓抗凝治疗[J].中国志,2003;23(4)：202-205.
[38]杨刚,吕厚山等.低分子肝素预防人工髋、膝关节置换术后下肢深静脉血栓形的研究.中华外科杂志.2000;1(38)：25-27.
[39]Lee CH, Hankey GJ,Ho WK, et al.Venousthromboembolism:diagnosis and management of deep venous thrombosis [J]. Med J Aust,2005; 182 (9):476-481.
[40]Khan A, et al. Dislocation following total hip preplacement. J Bone Joint Surg,1981;63B:214.
[41]Pierchon F, Pasquier G, Cotton A, et al. Causes of dislocation of total hip arthroplasty JBJS,1994;76:45-49.
[42]Buohhot ZHW, Ilson RA,Lodenkanper H. Management of dleep infections of total hip replacement[J].J Bone Jiont Surg,1981;6313(4):342.
[43]龙树明,吴术红,刘毅等.人工股骨头置换治疗老年不稳定性股骨粗隆间骨折[J].实用临床医学,2006：7(4)：57.
[1]俞强,林欣.股骨粗隆间骨折的治疗.河北医学,Apr 2004;10(4)：376-378.
[2]王亦璁.骨与关节损伤[M].第3版.北京：人民卫生出版社,2001：865-871.
[3]洪云飞,康智,王琦等.老年人股骨粗隆间骨折内固定手术术前评估及术后并发症原因分析[J].中原医刊,2006;33(5)：13.
[4]Davidson CW, Merrilees MJ, Wilkinson TJ, et al. Hip fracture mortality and morbidity can we do better? N Z Med J,2001,114(1136):329.
[5]Larsson S, Friberg S, Hansson LT.Trochanteric fracture:influence of reduction and implant position on impaction and complication. Clin Orthop,1990;259:130-139.
[6]朱江涛,卫晓春.股骨粗隆间骨折分型.实用骨科杂志.2007;7：410.
[7]胥少汀等.实用骨科学.人民军医出版社.2005;第三版：709.
[8]Evans EM. The treatment of trochanteric fracture of the femur[J].J Bone Joint Surg(Br),1949;31:190-193.
[9]Jensen JS, Tondevold E, Sonne-Holm S. Stable trochanteric fractures, A comp-arative analysis of four methods of internal fixation[J]. Acta Orthop Scand,1980;51(5):811-816.
[10]Mullerler ME, Nazarian S, Koch P. The Comprehensive Classification of Frac-tures of the Long Bones. New York:Springer-Verlag,1990:118.
[11]李亚东,刘长贵,王宝军等.老年人股骨粗隆间骨折骨牵引治疗的临床分析[J].中国临床医生,2005;5：30-32.
[12]王亦璁,主编.骨与关节损伤[M].第4版,北京：人民卫生出版社,2007：1184-1191.
[13]危杰.股骨转子间骨折[J].中华创伤骨科杂志,2004;5：554-557.
[14]Lindskog DM, Bnamgaertner MR. Unstable intertroehantefic hip fractures in the eldly[J].Am Acad Orthop Surg,2004;12:179-190.
[15]Parker MJ, Handoll HH. Extramedullary fixation implants and external fix-atorns for extracapsular hip fractures[J]. Cochrane Database SystRev, 2002;2:CD000339.
[16]陈立,麦庆春.单臂多功能外固定支架治疗老年股骨粗隆间骨折[J].按摩与导引,2006：22：35-36.
[17]Wolfang GL, Bryant MH, O'Neill JP. Treatment of intertroehanteric fracture of the femur using sliding serew plate fixation. Clin Orthop,1982;163: 148.
[18]闰洪印,陈楠.股骨粗隆间骨折早期内固定的手术治疗选择[J].骨与关节损伤杂志,2002：17：148.
[19]张伯松等,股骨转子间骨折与股骨颈骨折内固定失败后行人工髋关节置换术后比较[J].中华创伤骨科杂志,2002：4(3)：202-205.
[20]袁宏等.95°髁钢板与Richards钉治疗老年转子间骨折.骨与关节损伤,2000;15(4)：305-306.
[21]KrettekC. Fbrword:concepts of minimally invasive plateosteosynthesis [J]. Injury,1997;28(Suppl):Al-2.
[22]Krettek C, Schandelmaier P, Miclau T, et al. Transarticular jiont reconst-ruction and indirect plate synthesis for complex distal supracondylar femoral fracture [J]. Injury,1997;28(Suppl):A31-41.
[23]Kregor PJ. Introdution[J], Injury,2001;32(Suppl):C1-2.
[24]张俊杰等,股骨远端LISS钢板倒置治疗复杂股骨粗隆间骨折[J].中国骨与关节损伤杂,2009：4：334-335.
[25]Levy RN. Siegel M. Sedlin ED. et al. Compli eat ions of Ender pin fixation basi-cervical, in tertroehanteric and subtroehanteric fractures of the hip. J Bone Joint Surg(Am),1953;65:66.
[26]Gurtler RA, Jaeobs RR, Jaeobs CR. Biomeehanical evaluation of the Ender's pin, the harris nail and the dynamic hips screw for the unstable intertr-oehanteric fracture. Clin Orthop,1986;206:109.
[27]Lautenschalger EP, Uonaghan P. Titanium nad titanium alloys asdental maeri-als[J].Jint Dent,2004;43:245-248.
[28]Haynes RC, Poll RG,Miles AW.Et al.Failure of femoral head fixation:a cadaveric of lag screw cutout with the Gamma locking nail and AO dynamic hip Screw[J].Injury,1997:28:337-341.
[29]赵昌平,冯和林,李增炎等.Gamma钉治疗70岁以上老年粗隆间骨折[J].实用骨科杂志,2005：5：449-450.
[30]Gotze B, Bormiare F, Weisc K, etal. Belashtahrkeit yon osetesynthesen beiin-stabilen perund subtrochanteren femudrakturen[J]. Ak. tuelle Trammato-l,1998;28:197-204.
[31]James P, Waddell, Jnae Morton, et al. The role of total hip replacement in interchnateric fractuers of the femur [J]. Clinical Orthop and Related Research,2004;429:49-53.
[32]Rodop 0, Kiral A, Kaplan H, et al. Primary bipolar he miprosthe sis for unstable intertrochanteric fracture. Int Orthop,2002;6:233.
[33]Broos PL, Rommens PM, Greens VR, et al. Pertrochanteric fractures in the elderly. Is the Belgian VDP prosthesis the best treatment for unstable fractures with severe comminution Acta Chir Belg,1991;91:242.
[34]纪方,朴润秀,蔡郑东等.人工假体置换治疗高龄老年人不稳定粗隆间骨[J].骨与关节损伤杂志,2002：9：184-185.
[35]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[36]尤佳,姜文学等.人工双极股骨头置换治疗老年股骨粗隆间不稳定骨折.中国骨与关节损伤杂志,2006;21(8)：637.
[37]Cases CK,Gurder S, Gill. Cemented hemiarthroplasties for elderly pa-tients with intertrochanteris fractures[J].Clin Ortho,2000;2:206-215.
[38]朱天岳.不应将人工股骨头置换的适应证扩大到股骨粗隆间骨折[J].临床骨科杂志.2004：1：78.
[39]毛宾尧,陆勇等.人工股骨头置换治疗高龄股骨转子间骨折,中华创伤骨科杂志.2004：6(9)：1053-1055.
[40]Rodop O,Kiral A. Primary bipolar hemiprosthesis for unstable intertro-chanteric fractures. Int Orthop,2002;26(41):233-237.
[41]Kesemenli C, Subasi M, Arslan H. Treatment of intertroehanteric fractures in elderly patients with Leinbach type endoprosthesis.Ulus Trauma Derg,2001;7(4):254-254.
[42]Haentjens, P;Lamraski, G.Endoprosthetic replacement of unstable, comminu-ted intertrochanteric fracture of the femur in the elderly, osteopor-otic patient.Disabil Rehabil.2005 Sep 30 Octl5;27(18-19):1167-80.
[43]高雁卿,左立新等.高龄转子间骨折人工股骨头置换相关问题.临床骨科志.2004;7(1)：21-22.
[44]韩小松,向柄彦,邓江等.人工关节置换治疗高龄股骨粗隆间骨折,现代医药卫生.2007：23(19)：2867-2868.
[45]张国鑫,谷长跃,李延明等.人工全髋关节置换翻修术术前假体松动的回顾性研究[J].中国骨与关节损伤,2007;21(12)：831-833.
[46]裴福兴,邱贵兴.关节外科聚焦[M].北京：人民军医出版社,2007：252-256.
[47]Jasty M, Maloney WJ, Bragdon CR etal. The initiation of failure in cemented femoral components of hip arthroplasties [J]. J Bone Jiont Surg Br,1991; 73(4):551-558.
[48]Delee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement[J].Clin Orthop,1976;121:20-32.
[49]Gruen TA, Mcniece GM, Amstutz HC.'Modes of failure'of cemented stemtype femoral component:a radiographic analysis of loosening [J]. Clin Orthop, 1979:141:17-27.
[50]Duncan CP, MasriBA. Fractures of the femur after hip replacement. Instr-Course Lect,1995:44:293-304.
[51]张炅等,股骨假体周围骨折手术治疗策略.中华关节外科杂志.2009;10(5)：558-565.
[52]管东辉,LISS接骨板治疗假体稳定型全款关节置换术后股骨假体周围骨折8例报告.山东医药.2009：49(2)：41.
[53]龙浩等,人工股骨头置换术后股骨头脱位的原因分析.中华关节外科杂志.2009;8(4)：463-470.
[54]朱通伯,戴尅戎.骨科手术学.北京.人民卫生出版社,1998;2版：636.
[55]刘明轩,曹成福,张启宽等.长柄人工髋关节置换治疗高龄股骨转子间骨折的实验及临床研究.骨与关节损伤杂志,2003;18(7)：444-446.
[56]刘胜厚等.长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究.医学与哲学.2008：29(8)：29-31.
[57]卢晓栋等,股骨矩替代型人工关节治疗股骨转子间骨折21例分析.天津医药.2009：37(4)：319-321.
[58]BalBS, MaurerBT, HarrisWH. Trochantericunion following revision total hip arthroplasty[J].JArthroplasty,1998;13:29-33.
[59]黄小强,带大粗隆柄人工关节置换治疗高龄股骨粗隆间骨折76例.第四军医大学学报,2006：27(5)：450.
[60]杜建层等.他汀类药物防治骨质疏松症[J].中国骨质疏松志,2004;10(1)：109.
[61]廖二元,谭利华.代谢性骨病学[M].北京：人民卫生出版社,2003：630-716.