Ⅰ期全髋关节置换术治疗股骨转子下骨折合并同侧股骨头坏死

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Abstract Objective To evaluate the clinical and radiological results of one stagetotal hip arthroplasty(THA) in the treatment ofsubtrochanteric femoral fractures combined with ipsilateral avascular necrosis of the femoral head.Methods From June 2009 to May 2018，7 patients(7 hips) with subtrochanteric femoral fractures combined with ipsilateral avascular necrosis of the femoral head were treated by one stage THA using an uncemented fully porous-coated long femoral stem prosthesis in our department.There were five males and two females，with an average age of (67.58±7.89)years old.According to the Seinsheimer's classification，there was 5 type ⅡB，2 type ⅢA.According to the Ficat's classification，they were all type Ⅳ.Results here were no intra-operative complications such as femoral perforations and femoral fractures.The operation time for this serieswas (111.00±29.18)min.The intraoperative blood loss was (465.00±150.45)mL.All the patients were followed up，the follow-up time was(32.00±13.56) months.At last follow-up，all patients were able to walk independently.The HHS scorewas (89.00±8.28).And according to the HHS score，it wasexcellent in 5 patients，good in 1patients，and fair in 1 patients，andthe good and excellent ratings was 85.71%.All fractures got bone union with average union time(4.30±1.03)months.All the acetablar and femoral stem showed stable prosthesis.There were no infection，deep vein thrombosis，dislocation and aspetic loosening.Conclusion One stage THA in the treatment ofsubtrochanteric femoral fractures combined with ipsilateral avascular necrosis of the femoral head can provide a single operation that both stabilized the fracture and eliminated hip disease.An uncemented fully porous-coated long femoral stemsprovides a good intramedullary fracture stability that promotes fracture healing.

Key words： subtrochanteric fracture avascular necrosis of the femoral head arthroplasty

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