| 髋关节置换术中肢体长度控制方法的病例对照研究 |
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投稿时间：2015-09-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 张阳阳 |
ZHANG Yang-yang |
吉林大学中日联谊医院骨科, 吉林 长春 130031 |
Department of Orthopaedics, China Japan Union Hospital, Jilin University, Changchun 130031, Jilin, China |
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| 左建林 |
ZUO Jian-lin |
吉林大学中日联谊医院骨科, 吉林 长春 130031 |
Department of Orthopaedics, China Japan Union Hospital, Jilin University, Changchun 130031, Jilin, China |
jlzuojianlin@163.com |
| 高忠礼 |
GAO Zhong-li |
吉林大学中日联谊医院骨科, 吉林 长春 130031 |
Department of Orthopaedics, China Japan Union Hospital, Jilin University, Changchun 130031, Jilin, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第2期，第102-106页 |
| DOI：10.3969/j.issn.1003-0034.2016.02.002 |
| 基金项目:吉林省自然科学基金重点科技攻关项目基金资助(编号:20130206102SF) |
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中文摘要:
目的:通过引入一种新型测量工具,结合术前设计,可精确控制术后肢体长度,为髋关节置换术术中控制肢体长度提供一种方便有效的方法.
方法:自2013年1月至2014年9月收治102例需行单侧髋关节置换的患者,应用新方法控制肢体长度作为试验组,共51例,男25例,女26例;年龄37~92岁,平均60.41岁.应用常规方法(如shuck test,触摸对侧肢体长度等)控制肢体长度作为对照组,共51例,男27例,女24例;年龄35~87岁,平均61.00岁.102例手术均由同一术者完成.试验组患者行全髋关节置换术治疗单侧股骨头缺血性坏死或股骨颈骨折35例,行双极股骨头置换术治疗单侧股骨颈骨折16例;对照组行全髋关节置换术治疗单侧股骨头缺血性坏死或股骨颈骨折38例,行双极股骨头置换术治疗单侧股骨头缺血性坏死或股骨颈骨折13例.在术后标准双髋正位X线片测量双侧偏心距a,股骨头旋转中心相对于大粗隆高度b,小粗隆高点到双侧泪滴连线垂直距离c.然后取双侧测量值差的绝对值作为判断肢体长度的评价指标,分别是:d1,双侧偏心距之差的绝对值;d2,双侧股骨头旋转中心相对于大粗隆高度之差的绝对值;d3,双侧小粗隆高点到双侧泪滴连线距离之差的绝对值.对两组患者的数据进行统计处理.
结果:试验组和对照组患者d1分别为4.49、7.32 mm;d2分别为2.37、4.32 mm;d3分别为3.32、6.08 mm;试验组患者d1、d2、d3均小于对照组.
结论:新型测量工具及方法可有效控制髋关节置换术后肢体长度和头颈偏距. |
| 【关键词】关节成形术,置换,髋 放射测量术 髋关节 病例对照研究 |
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| Case-control study on methods of limb length control in hip arthroplasty |
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ABSTRACT
Objective:To introduce a new measuring tool for measuring postoperative limb length exactly,and to provide a convenient and effective method to control limb length after total hip replacement.
Methods:From January 2013 to September 2014,102 patients undergoing primary unilateral hip replacement were divided into two groups:experimental group and control group. There were 51 patients in the experimental group,including 25 males and 26 females,ranging in age from 37 to 92 years old,with an average of 60.41 years old. The patients in experimental group were treated with new method to control limb length. Other 51 patients in the control group,including 27 males and 24 females,ranging in age from 35 to 87 years old,with an average of 61.00 years old. The patients in the control group were treated with normal methods such as shuck test or limb touching. All the patients were operated by the same experienced surgeon. In the experimental group,total hip arthroplasties (THA) were performed on 35 patients with avascular necrosis of the femoral head or femoral neck fracture,and 16 patients were treated with hemiarthroplasty (HA). In the control group,38 patients received THA and 13 patients received HA. On the anterior-posterior X-ray radiograph,several indexes were measured as follows:the distance of bilateral femoral offset(a),the height from tip of great trochanter to the rotation center of the femoral head (b) and the vertical distance between the top of the minor trochanter and the two tear drops line(c). The leg length discrepancy can be assessed with three parameters as follows:d1,the absolute value of the difference between the bilateral a values;d2,the difference between the bilateral b values;d3,the difference between the bilateral c values. The SPSS 21.0 was applied for the statistical analysis.
Results:In the experimental and control groups,d1 were 4.49 mm and 7.32 mm(P=0.013);d2 were 2.37 mm and 4.32 mm(P=0.033); d3 were 3.32 mm and 6.08 mm (P=0.031). The values of d1,d2 and d3 in the experimental group were significant smaller than those in the control group.
Conclusion:The new measuring tool and method can be used to control the limb length and offset effectively during operation. |
| KEY WORDS Arthroplasty,replacement,hip Radiometry Hip joint Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张阳阳,左建林,高忠礼.髋关节置换术中肢体长度控制方法的病例对照研究[J].中国骨伤,2016,29(2):102~106 |
| 英文格式: | ZHANG Yang-yang,ZUO Jian-lin,GAO Zhong-li.Case-control study on methods of limb length control in hip arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(2):102~106 |
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