摘要
目的探讨SuperPATH微创入路人工全髋关节置换术(THA)下肢等长控制方法及效果。方法自2016年2月～2017年9月,对我院50例采用SuperPATH微创入路THA患者,通过术前影像学评估、模板测量、计算股骨柄假体最高点与大转子顶点距离,术中C臂机拍摄两侧髋关节和股骨近段正位片,测量大转子顶点、小转子最下缘或高点与两侧坐骨结节最低点连线的垂直距离,比较左右侧位置关系,选择相应颈长、调整股骨柄打入深度及股骨头的增减型号来调整肢体长度趋于等长。结果所有患者均获得随访,时间6～18(8.0±0.5)个月。切口愈合瘢痕长度5.4～7.5(6.0±0.4)cm。术后6个月回院复查时Harris评分82～93(86.0±2.5)分,术后双下肢长度相等47例,不相等3例(0.3～0.7 cm)。结论 SuperPATH微创入路THA术,术前应用模板在X片上测量精确预算,术中通过臼深、截骨位置调整、不同型号假体组件组合、再次X线透视精确再评估等措施控制下肢长度的方法能使患者术后双下肢获得等长。
Objective To investigate the methods and effectiveness of SuperPATH minimal invasive approach on the lower limb isometric control of total hip arthroplasty（THA）. Methods 50 patients who were treated with SuperPATH minimal invasive approach of THA in our hospital from February 2016 to September 2017 were selected. The distance between the highest point of femoral stem prosthesis and greater trochanter tip was calculated using preoperative imag- ing evaluation and template measurement. The vertical dimensions between greater trochanter tip, lesser trochanter low- est edge/high point and the line of bilateral sciatic tubercle lowest points were measured using posteroanterior radio- graph of bilateral hip joints and proximal femur filmed by C-arm fluoroscopy. The relationship between the locations of two sides was compared. Selection of corresponding femur body length, adjustment of femoral stem penetration depth and regulation of femoral head type specification were used to adjust the limb length to be equilong. Results Follow-up visit was paid in all the patients and the follow-up duration was 6-18（8.0±0.5） months. The length of incision was 5.4- 7.5（6.0±0.4） cm. The score of Harris 6 months after operation was 82-93（86.0±2.5）. Both lower extremities of 47 pa- tients were equilong while those of 3 patients were not（0.3-0.7 cm）. Conclusion SuperPATH minimal invasive approach of THA could make both lower extremities equilong after the operation by the accurate pre-calculation of template us- ing X-ray before the operation, the adjustment of trochanter depth and osteotomy position, combination of different type specification of prosthesis components and accurate re-evaluation of X-ray during the operation.
作者
季卫平
吴博
王波
何世杰
王小玲
梁娟
JI Weiping;WU Bo;WANG Bo;HE Shijie;WANG Xiaoling;LIANG Juan(Department of Orthopedics,Lishui City People＇s Hospital,6th Affiliated Hospital of Wenzhou Medical University,Lishui 323000,China)
出处
《中国现代医生》
2018年第25期90-94,169,共6页
China Modern Doctor
基金
浙江省基础公益研究计划项目(LGF18H060004)
浙江省医药卫生科技计划项目(2018ZH061)
关键词
微创
置换
髋
髋关节
下肢
Minimal invasive
Replacement
Hip
Hip joint
Lower limbs
