摘要
目的探讨利用Bryant三角标志术中均衡下肢长度以预防全髋置换术后肢体不等长的效果。方法 126例单侧全髋关节置换术患者,术前体检及X线片测量两侧肢体长度差,估计假体型号和位置,术中依据大转子到Bryant三角顶点标记点之间的距离变化平衡下肢长度。结果 126例随访3～26(9.5±0.5)个月。术前肢体长度差比例为:0～5mm者占20.6%,5～10mm者占46.0%;10～15mm者占16.7%;15～20mm者占10.3%,>20mm者占6.4%;通过平衡肢体长度差,术后双下肢长度差比例为:0～5mm者占50.8%,5～10mm者占33.3%,10～15mm者占7.9%,15～20mm者占5.6%,>20mm者占2.4%。术后脱位牵引复位2例,坐骨神经痛1例,大腿疼痛3例,相应治疗后缓解。结论全髋关节置换术中利用Bryant三角标志平衡下肢长度预防肢体不等长效果优良,能明显提高术后患者满意率,减少医疗纠纷发生。
Objective To study the prevention of leg length discrepancy by measurement marked with Bryant triangle during total hip arthroplasty.Methods 126 cases undergoing the unilateral primary total hip arthroplasty were retrospectively studied.The extent of limb length discrepancy was preoperatively evaluated by clinical and radiographic measurements,and the suitable size and place for the prosthetic implantation were predicted.The distance between Bryant triangle marked point and greater trochanter was detected and used to achieve limb length equality during operation.Results 126 cases were followed up for 3～26（9.5±0.5）.Preoperatively,the leg length discrepancy were 0～5mm in 20.6%,5～10 mm in 46.0%;10～15 mm in 16.7%;15~20 mm in 10.3%,and ﹥20mm in 6.4%.After operation,the leg length discrepancy were improved to 0～5 mm in 50.8%,5～10 mm in 33.3%,10～15 mm in 7.9%,15～20 mm in 5.6%,and 20 mm in 2.4%.Luxation happened in 2 cases and cured by traction reduction,and there were thigh pain in 3 cases and sciatic nerve pain in 1 case,which were eased by corresponding treatment.Conclusions Measureing the distance between Bryant triangle marked point and greater trochanter to prevent limb discrepancy during total hip arthroplasty is a very effective way.
出处
《临床骨科杂志》
2010年第3期269-270,共2页
Journal of Clinical Orthopaedics
