大腿骨頚部骨折に対するセメント使用，非使用人工骨頭置換術の前向き研究

Prospective Study of Cemented or Cementless Bipolar Hemiarthroplasty for Femoral Neck Fracture

　高齢者大腿骨頚部骨折に対してセメント使用および非使用の人工骨頭置換術を無作為に行いX線学的に検討した．その結果，セメント非使用の13例中2例で術後早期に2mm以上のステムの沈下が生じた．この2例のcortical index（CI）は0.4以下であったが，セメント使用例ではCI 0.4未満が4例存在するにもかかわらず，ステムの初期固定性は良好であった．以上の結果からCIが低値を示す例では，人工骨頭置換術施行の際にセメントを使用することが望ましいと考えられた．

　In the present study we show the results of a prospective randomized-controlled study on the clinical result of hemiarthoroplasty for femoral subcapital fractures. We randomly performed bipolar hemiarthoroplasty (BHA) with or without bone cement, and radiographic findings were evaluated at 3 months after surgery. In our cases, sinking of stems more than 2 mm occurred in 2 of 13 cases in patients who underwent cementless BHA. The cortical Index (CI) of these 2 cases was less than 0.4. However,sinking of the stems occurred in 4 cases where the CI was under 0.4 in patients who underwent cemented BHA. The above findings suggested that cemented BHA was preferable for patients with femoral subcapital fracture whose CI was equal to or less than 0.4.