摘要
目的:分析初次全髋置换术(pTHR)中髋臼骨折的原因和治疗结果,探讨预防和治疗方法。方法:2004年7月至2006年12月,326例pTHR病历记载中11例术中出现髋臼骨折,女7例,男4例;年龄37～71岁,平均54岁。分析骨折原因、解剖位置、治疗方法和结果,对髋臼假体进行分类,评估导致骨折的风险因素。结果:11例中,6例为打压安装髋臼假体时发生,3例是磨钻髋臼时发生,2例是安放Homman拉钩时发生。包括5例中央型骨折,3例为后方(后壁),2例为前方,1例为后上方。9例获得随访,随访时间12～29个月,平均18个月,无异位骨化,无脱位和深静脉栓塞,所有的骨折均愈合。结论:髋臼骨折在非骨水泥型全髋置换术中并非罕见,需要重视。但在对髋臼假体进行牢固固定,获得初始稳定性后仍可获得骨长入,近期治疗结果良好。
Objective ：To analyse the causes and resuhes of intraoperative occurrence of an aeetabular fracture in primary total hip arthroplasty and discuss propriate prevention and treatment of this problem. Methods：Between July 2004 and December 2006,326 primary total hip arthroplasties were retrospectively reviewed and found that eleven patients （eleven hips） had sustained an intraoperative aeetabular fracture involving 7 male and 4 female, aged from 37 to 71 years （mean 54 years）. Analyzed the causes of fractures ,the anatomic location ,treatment and outcome of the fractures. Aeetabular component designs were categorized and each design was analyzed for fracture risk. Results： Among 11 cases, the fractures occurreneed as setting the prosthesis in 6 cases, grinding and drilling in 3 cases, drawning hook in 2 cases. There were 5 cases of central type fracture,3 of posteriorowall,2 of anterior, 1 of posterior-upper. Nine of these patients （nine hips） had been followed-up for 12 to 29 months （mean 18 months）. There were no heterotopic ossification, no dislocation, no deep venous embolism. All fractures were healing. Conclusion ： Acetabular fracture during primary total hip arthroplasty is a complication of acetabular fixation without cement, which should be think highly of. In the present series, retention of a stable cup is associated with uneventful osseous in growth and excellent early-term outcomes.
出处
《中国骨伤》
CAS
2009年第2期81-83,共3页
China Journal of Orthopaedics and Traumatology
关键词
关节成形术
置换
髋
髋臼
骨折
Arthroplasty,replacement,hip
Acetabulum
Fractures
