临床外科杂志 ›› 2026, Vol. 34 ›› Issue (6): 692-695.doi: 10.3969/j.issn.1005-6483.20250358

• 论著 • 上一篇    下一篇

生物型加长柄、骨水泥型长柄人工股骨头置换治疗股骨转子间骨折的疗效比较

陈星晨,柯贤鹏   

  1. 商洛市中心医院创伤骨科
  • 收稿日期:2025-04-08 出版日期:2026-08-18 发布日期:2026-08-18
  • 通讯作者: 柯贤鹏
  • 作者简介:陈星晨,柯贤鹏
  • 基金资助:
    陕西省自然科学基础研究项目(2022JM-554)

Comparison of clinical efficacy between biotype extended stem and cemented long stem prosthetic femoral head replacement in the treatment of intertrochanteric femoral fractures

CHEN Xingchen,KE Xianpeng   

  1. Department of Trauma Orthopedics,Shangluo Central Hospital
  • Received:2025-04-08 Online:2026-06-20 Published:2026-08-18

摘要: 目的 探讨生物型加长柄和骨水泥型长柄人工股骨头置换治疗股骨转子间骨折病人的临床疗效。方法 2021年6月~2023年6月收治的股骨转子间骨折病人96例。根据人工股骨头置换治疗所用股骨柄类型,分为两组,观察组48例,采用生物型加长柄,对照组48例,采用骨水泥型长柄。比较两组围术期指标、髋关节功能、疼痛程度、骨折愈合效果及住院期间并发症发生率。结果 观察组和对照组首次下床时间分别为(1.07±0.26)天和(3.21±0.41)天,手术时间分别为(55.27±7.52)分钟和(62.15±7.79)分钟、住院时间分别为(13.59±2.44)天和(18.25±4.68)天,术中出血量分别为(274.13±32.48)ml和(98.15±32.63)ml],两组比较差异有统计学意义(P<0.05);观察组术后1个月及3个月HHS评分分别为(75.79±4.25)分和(89.29±4.31),对照组分别为(68.19±5.28)分和(82.35±5.84),两组比较差异有统计学意义(P<0.05)。观察组术后1个月及3个月VAS评分分别为(4.23±1.33)分和(1.89±0.61)分,对照组分别为(3.63±1.08)分和(1.52±0.37)分,两组比较差异有统计学意义(P<0.05);两组术后6个月及12个月HHS及VAS评分比较,差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 生物型加长柄人工股骨头置换治疗可促进股骨转子间骨折病人术后早期功能恢复并缩短住院时间,但术中出血较多,且术后3个月内疼痛缓解不及骨水泥型长柄,二者在术后6个月及12个月功能恢复和疼痛缓解方面无明显差异,股骨柄选择应结合病人具体情况综合考量。

关键词: 生物型加长柄; 骨水泥型长柄; 股骨头置换; 股骨转子间骨折; 疗效

Abstract: Objective To explore the clinical outcomes of biological extended-stem versus cemented long-stem femoral head replacement in patients with intertrochanteric femoral fractures. Methods A total of 96 patients with intertrochanteric femoral fractures who were admitted to Shangluo Central Hospital from June 2021 to June 2023 were selected.Based on the type of femoral stem used,the patients were divided into an observation group (48 cases,treated with a biotype extended stem) and a control group (48 cases,treated with a cemented long stem).Perioperative indicators,hip joint function,pain level,fracture healing outcomes,and the incidence of complications during hospitalization were compared between the two groups.Results The observation group had significantly shorter time to first ambulation,operation time,and hospital stay compared to the control group [(1.07±0.26) days vs.(3.21±0.41) days,(55.27±7.52) min vs. (62.15±7.79) min,and (13.59±2.44) days vs. (18.25±4.68) days,respectively;P<0.05].However,the intraoperative blood loss in the observation group was significantly higher than that in the control group [(274.13±32.48) ml vs. (98.15±32.63) ml,P<0.05].The HHS scores of the observation group at 1 month and 3 months after the operation were (75.79±4.25) points and (89.29±4.31) points respectively,while those of the control group were (68.19±5.28) points and (82.35±5.84) points respectively.There was a statistically significant difference between the two groups (P<0.05).The VAS scores of the observation group at 1 month and 3 months after the operation were (4.23±1.33) points and (1.89±0.61) points respectively,while those of the control group were (3.63±1.08) points and (1.52±0.37) points respectively.There was a statistically significant difference between the two groups (P<0.05).There was no statistically significant difference in HHS and VAS scores between the two groups at 6 months and 12 months after surgery (P>0.05).No significant differences were observed in the incidence of postoperative complications between the two groups (P>0.05). Conclusion The biotype extended stem can promote early postoperative functional recovery and shorten hospital stay,but is associated with greater intraoperative blood loss and slower early pain relief compared to the cemented long stem.By 6 and 12 months postoperatively,there is no significant difference in functional recovery or pain relief between the two,suggesting that the choice of femoral stem should be made based on the specific conditions of the patient.

Key words: biotype extended stem; cemented long stem; femoral head replacement; intertrochanteric femoral fracture; clinical efficacy

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