目的探讨影响股骨偏心距重建的相关因素,为全髋关节置换术中偏心距的重建提供参考。方法对初次行人工全髋关节置换术(total hip arthroplasty,THA)的111例111髋术后X线片进行测量,测量健侧的颈干角、偏心距,患侧术后的偏心距及旋转中心...目的探讨影响股骨偏心距重建的相关因素,为全髋关节置换术中偏心距的重建提供参考。方法对初次行人工全髋关节置换术(total hip arthroplasty,THA)的111例111髋术后X线片进行测量,测量健侧的颈干角、偏心距,患侧术后的偏心距及旋转中心的重建情况,结合假体的颈干角及颈长,通过统计学分析,探讨偏心距的重建与旋转中心的重建、假体颈干角、假体颈长的相关性。结果偏心距的重建与旋转中心的重建有明显相关性(X^2=10.12,P<0.005,r=0.48)。与健侧颈干角相比,假体颈干角较小的病例比颈干角较大的病例能更好的重建偏心距;健患侧颈干角相差范围控制在3°以内可使患侧偏心距获得较好的重建;不同假体之间偏心距的重建没有差别(X^2=0.411 1,P>0.05)。各长短颈的假体偏心距重建在统计学上没有差别(X^2=1.242 0,P>0.05)。结论 THA术中要重建偏心距,首先要尽量恢复髋关节的旋转中心;其次要选择适宜的颈干角假体,即使不能选择解剖型的颈干角假体,也要选择接近解剖颈干角的假体,二者的相差范围应在3°以内;最后要考虑假体的颈长,综合多因素作个体化选择。展开更多
AIM To evaluate the results of the Ilizarov method in management of cases with bone loss, soft tissue loss and infection.METHODS Twenty eight patients with severe leg trauma complicated by bone loss, soft tissue loss ...AIM To evaluate the results of the Ilizarov method in management of cases with bone loss, soft tissue loss and infection.METHODS Twenty eight patients with severe leg trauma complicated by bone loss, soft tissue loss and infection were managed by distraction osteogenesis in our institution. After radical debridement of all the infected and dead tissues the Ilizarov frame was applied, corticotomy was done and bone transport started. The wounds were left open to drain. Partial limb shortening was done in seven cases to reduce the size of both the skeletal and soft tissue defects. The average follow up period was 39 mo(range 27-56 mo). RESULTS The infection was eradicated in all cases. All the soft tissue defects healed during bone transport and plastic surgery was only required in 2 cases. Skeletal defects were treated in all cases. All patients required another surgery at the docking site to fashion the soft tissue and to cover the bone ends. The external fixation time ranged from 9 to 17 mo with an average of 13 mo. The complications included pin tract infection in 16 cases, wire breakage in 2 cases, unstable scar in 4 cases and chronic edema in 3 cases. According to the association for study and application of methods of Ilizarov score the bone results were excellent in 10, good in 16 and fair in 2 cases while the functional results were excellent in 8, good in 17 and fair in 3 cases. CONCLUSION Distraction osteogenesis is a good method that can treat the three problems of this triad simultaneously.展开更多
文摘AIM To evaluate the results of the Ilizarov method in management of cases with bone loss, soft tissue loss and infection.METHODS Twenty eight patients with severe leg trauma complicated by bone loss, soft tissue loss and infection were managed by distraction osteogenesis in our institution. After radical debridement of all the infected and dead tissues the Ilizarov frame was applied, corticotomy was done and bone transport started. The wounds were left open to drain. Partial limb shortening was done in seven cases to reduce the size of both the skeletal and soft tissue defects. The average follow up period was 39 mo(range 27-56 mo). RESULTS The infection was eradicated in all cases. All the soft tissue defects healed during bone transport and plastic surgery was only required in 2 cases. Skeletal defects were treated in all cases. All patients required another surgery at the docking site to fashion the soft tissue and to cover the bone ends. The external fixation time ranged from 9 to 17 mo with an average of 13 mo. The complications included pin tract infection in 16 cases, wire breakage in 2 cases, unstable scar in 4 cases and chronic edema in 3 cases. According to the association for study and application of methods of Ilizarov score the bone results were excellent in 10, good in 16 and fair in 2 cases while the functional results were excellent in 8, good in 17 and fair in 3 cases. CONCLUSION Distraction osteogenesis is a good method that can treat the three problems of this triad simultaneously.
