股骨大转子延长截骨在假体稳定股骨柄翻修中的应用
康鹏德;裴福兴;沈彬;周宗科;杨静
【期刊名称】《中华外科杂志》 【年(卷),期】2009(047)003
【摘要】目的 评估大转子延长截骨在股骨假体固定稳定型全髋关节翻修术中应用的中期临床效果.方法 1998年1月至2005年6月对27例患者(27髋)采用大转子延长截骨对股骨柄和(或)骨水泥壳固定稳定的全髋关节翻修.临床随访评估包括Harris评分和WOMAC评分,术前Harris评分平均42.7分,WOMAC评分平均55.6分;影像学评估包括术后拍摄X线片,对比观察截骨块愈合时间、是否存在截骨延迟愈合或不愈合,截骨块是否发生移位以及假体是否下沉等.结果 共19例患者(19髋)获得随访,平均随访时间5.3年.无一例发生术中或术后骨折.术后Harris评分平均87.3分,WOMAC评分平均46.3分.所有患者大转子截骨块均于术后6个月内愈合.无股骨大转子截骨块向近端移位,3例发生股骨柄下沉,平均下沉3.4 mm,无钢丝断裂.结论 对于假体固定稳定型股骨柄翻修,采用股骨大转子延长截骨有利于手术操作和翻修假体的植入和固定,有利于截骨块的愈合,降低术中、术后并发症发生率,中期疗效显著.%Objective To analyze the clinical and radiographic results of the extended trochanteric osteotomy in revision total hip arthroplasty procedure. Methods The data of 27 patients (27 hips) of the clinical and radiographic results were reviewed between January 1998 and June 2005. There were 16 men and 11 women, and the mean age at the time of revision surgery was 63 years (range 42 to 78 years). Indications for use of the trochanteric osteotomy
were removal of well-fixed femoral implants. Clinical evaluation included Harris and WOMAC scores. The radiological evaluation included stem subsidence, trochanteric fragment fractures and stem position change. Results Nineteen patients (19 hips) were followed up for an average of 5.3 years. All osteotomy sites healed by 16 months, with an average time to union of 16 weeks. No intraoperative fracture at the osteotomy site occurred. There was only one disclocation postoperatively. Three femoral components were subsidence at a mean of 3.4 mm (range 3-7 mm) in the first 6 weeks postoperatively; It united within 6 months without further migration.Conclusions The extended trochanteric osteotomy facilitates the removal of well-fixed femoral implants, allows reliable reattachment of the trochanteric fragment and results an excellent rate of healing and implant stability in revision total hip arthroplasty during midterm follow-up. Long-term follow-up is needed. 【总页数】4页(177-180)
【关键词】关节成形术,置换,髋;截骨术;大转子延长截骨;并发症 【作者】康鹏德;裴福兴;沈彬;周宗科;杨静
【作者单位】610041,成都,四川大学华西医院骨科;610041,成都,四川大学华西医院骨科;610041,成都,四川大学华西医院骨科;610041,成都,四川大学华西医院骨科;610041,成都,四川大学华西医院骨科 【正文语种】中文 【中图分类】R6
【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-surgery_thesis/0201234902582.html 【相关文献】
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股骨大转子延长截骨在假体稳定股骨柄翻修中的应用
