摘要
[目的]探讨三种不同病因成人高位髋脱位行一期全髋置换治疗手术策略和疗效。[方法]2017年5月—2021年3月,对13例(17髋)不同病因成人高位髋脱位采用全髋置换术治疗,包括7例(11髋)为发育性髋脱位,2例为化脓性髋关节后遗髋骨关节病,4例为陈旧性髋关节后脱位。[结果]所有患者均顺利完成手术,手术伤口均一期愈合,无感染、深静脉血栓发生;术后短暂性股神经麻痹1例;术后脱位2例。随访时间平均(33.1±15.6)个月,与术前相比,末次随访患者VAS评分显著减少(P<0.05),髋屈-伸ROM、髋内-外旋ROM及Harris评分显著增加(P<0.05)。影像方面,粗隆下截骨愈合时间为4~8个月。末次随访时,双下肢不等长及纵向旋转中心和水平旋转中心均较术前显著改善(P<0.05),无假体松动者。[结论]成人高位髋脱位行THA治疗早中期疗效满意。
[Objective]To explore the clinical outcomes of one-stage total hip arthroplasty(THA)for high-displacement dislocation of the hip in adults.[Methods]From May 2017 to March 2021,13 patients(17 hips)underwent THA in our department for high-displacement dislocation of the hip due to congenital dislocation of the hip in 7 cases(11 hips),previous pyogenic hip osteoarthropathy in 2 cases,and unreduced traumatic posterior dislocation of the hip in 4 cases.[Results]All patients had THA performed successfully with well incision healing without infection and deep vein thrombosis,despite of the fact that temporary femoral nerve palsy in 1 case and re-dislocation in 2 cases were found,which were treated correspondingly without serious consequences.At the latest follow up lasted for(33.1±15.6)month the VAS score for pain significantly decreased(P<0.05),while the hip flexion-extension range of motion(ROM),external-internal rotation ROM and Harris score significantly increased compared with those preoperatively(P<0.05).In term of radiographic evaluation,the leg length discrepancy and position of rotate centers significantly improved at the latest follow up compared with those preoperatively(P<0.05),with osteotomy healed from 4 to 8 months postoperatively.[Conclusion]The one-stage THA used for high-displacement dislocation of the hip does achieve satisfactory mid-term clinical outcomes.
作者
龚志兵
吴昭克
庄至坤
郭金花
许志庆
张前进
林行会
吴荣凯
GONG Zhi-bing;WU Zhao-ke;ZHUANG Zhi-kun;GUO Jin-hua;XU Zhi-qing;ZHANG Qian-jin;LIN Xing-hui;WU Rong-kai(Department of Joint Surgery,Quanzhou Hospital of Traumatic Orthopedics,Fujian Unitersity of Troditional Chinese Medicine,Quanzhou 362000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第5期463-466,共4页
Orthopedic Journal of China
关键词
髋关节脱位
高移位
全髋关节置换术
dislocation of the hip
high displacement
total hip arthroplasty
