180 KB19 KB192920262003Andoljšek, MatejRjazancev, Borisstr. I-91-I-94ISSN:1318-0347COBISSID_HOST:16593881URN:URN:NBN:SI:doc-4BH56FM4slSlovensko zdravniško društvoZdravniški vestnikArthroplastyArtroplastikaFemoral Neck FracturesFemur, vrat, zlomiHip ProsthesisKolčni sklep, protezaSurgeryTreatment OutcomeZdravljenje, izidBipolarna artroplastika s steblom HP 2 v oskrbi zlomov stegneničnega vratu| Bipolar arthroplasty with HP 2 stem in treatment of fractures of the femoral neck| preliminarno poročilo| preliminary report|Background. In General Hospital Jesenice we started with arthroplasties in patients with a fracture of the femoral neck in 1985. At the beginning cemented stems were used. In 1991 modular self-tapping uncemented stem (HP 1; first generation) was introduced. Two years later bipolar head was added. In 1994 second generation of modular selftapping uncemented stem (HP 2) came intouse. In prospective study, early clinical results of bipolar arthroplasty with HP 2 stem in patients with a fracture of the femoral neck are evaluated. Methods and results. From 1994 to 1999, 332 fractures of the femoral neck wereoperated. Two hundred and thirtyfour prostheses were implanted, and of these, 123 were bipolar with HP-2 stem (one third of all patients). Patients were on average 78 years old, and women outnumbered men five to one. After an average hospital stay of three weeks, 80% of patients were able to ambulate; in 20% of patients rehabilitation failed. 88% of patients retained their preinjury social status. Hospital mortality was 4.4%. Complications were rare,and ended with reoperation in eleven patient, seven for early and four for late complications (two deep infections, two material failures; 3.5%). With minimal follow-up of two years, there was only one aseptic loosening of the HP 2 stem. Conclusions. This prospective study of early clinical results shows, that bipolar arthroplasty with a modular self-tapping uncemented stem (HP 2) is usefull mode of treatment in patients with a fracture of the femoralneckIzhodišča. Na kirurškem oddelku Splošne bolnišnice Jesenice delamo primarno artroplastiko pri zlomih stegneničnega vratu od leta 1985. Sprva smo tako za parcialne kot totalne proteze uporabljali izključno cementna stebla. Prvo modularno samovrezno necementno steblo (HP 1) smo vgradili leta 1992. Dve letikasneje smo prvič uporabili biartikularno glavo. Leta 1994 smo začeli uporabljati modularno samovrezno brezcementno steblo druge generacije (HP2). Vprispevku predstavljava zgodnje rezultate primarnih bipolarnih artroplastik zmodularnim samovreznim brezcementnim steblom HP 2 in ocenjujeva uporabnost bipolarne artroplastike s HP 2 steblom v oskrbi zlomov stegneničnega vratu. Metode in rezultati. V letih 1994-1999 smo z bipolarno artroplastiko s HP 2 steblom primaruo oskrbeli 113 zlomov stegneničnega vratu (tretjina zlomov stegneničnega vratu oskrbljenih v tem času). Poškodovanci so bili ob operacijipovprečno stari 78 let in med njimi je bilo štiri petine žensk. Povprečno so bili poškodovanci hospitalizirani tri tedne. V tem času se je uspešno rehabilitiralo 80 oseb, pri 20% rehabilitacija ni uspela. Kar 88% odpuščenih poškodovancev je ohranilo predpoškodbeni socialni status. Hospitalna umrljivost je bila 4,4%. Tako zgodnjih kot poznih lokalnih zapletovje bilo razmeroma malo. Ponovno smo operirali enajst poškodovancev, sedem zaradi zgodnjih in štiri zaradi poznih zapletov (dve globoki okužbi, dvezlomljeni protezi; 3,5%). Do decembra 2001 (minimalna opazovalna doba dve leti) smo v analizirani skupini poškodovancev zabeležili le eno klinično pomembno aseptično omajanje HP-2 stebla. Zaključki. Preliminarna analiza potrjuje uporabnost bipolarne artroplastike s HP 2 steblom v primarni oskrbi zlomov stegneničnega vratuTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo