大转子延长截骨钢丝固定结合自体骨屑植骨在全髋关节翻修术中的应用
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作者Author单位AddressE-Mail
唐慧斌 TANG Hui-bin 湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 Department of Orthopaedics,the First People's Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou 313000,Zhejiang,China  
孙振国 SUN Zhen-guo 湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 Department of Orthopaedics,the First People's Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou 313000,Zhejiang,China 775200057@qq.com 
翁伟 WENG Wei 湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 Department of Orthopaedics,the First People's Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou 313000,Zhejiang,China  
张占丰 ZHANG Zhan-feng 湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 Department of Orthopaedics,the First People's Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou 313000,Zhejiang,China  
杨红航 and YANG Hong-hang 湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 Department of Orthopaedics,the First People's Hospital of Huzhou,Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang,the First Affiliated Hospital of Huzhou Normal University,Huzhou 313000,Zhejiang,China  
期刊信息:《中国骨伤》2022年,第35卷,第4期,第333-337页
DOI:10.12200/j.issn.1003-0034.2022.04.006
基金项目:浙江省基础公益研究计划(编号:LGF20H060009)
中文摘要:

目的: 探讨采用大转子延长截骨钢丝固定加自体骨屑植骨进行全髋关节置换翻修的临床效果。

方法: 自2010年12月至2018年12月,应用大转子延长截骨钢丝固定结合自体骨屑植骨,行全髋关节置换翻修术患者18例,其中男8例,女10例;年龄68~82(78.89±3.32)岁;初次置换术后至翻修时间9~22(16.33±2.93)年。术后定期随访记录患者截骨块愈合时间、完全负重活动时间、髋关节Harris评分及并发症等情况。

结果: 纳入研究的18例患者均获得随访,时间16~38(25.78±6.65)个月。手术切口均Ⅰ期愈合。切口长度16~21(18.89±1.32) cm。手术时间105~128(115.44±6.59) min;出血量240~285(267.44±13.77) ml。截骨块愈合时间12~18(15.61±1.75)周;患者完全负重活动时间14~22(17.78±2.53)周。术前髋关节Harris评分(47.11±5.04)分,完全负重活动时髋关节Harris评分(76.39±3.85)分,末次随访时髋关节Harris评分(82.22±2.76)分,差异有统计学意义(P<0.05)。随访期间,患者均未发生患肢短缩、感染、切口愈合不良、假体松动及下沉、假体周围骨折等并发症。

结论: 在全髋关节置换翻修术时,应用大转子延长截骨钢丝固定结合自体骨屑植骨,能够获得满意的临床治疗效果,但需要术者对翻修术前、术中及术后恢复等各个时期做好系统规划。
【关键词】股骨  截骨术  骨移植  骨固定钢丝  关节成形术,置换,髋  再手术
 
Application of extended trochanter osteotomy wire fixation combined with autologous bone graft in revision of total hip arthroplasty
ABSTRACT  

Objective: To investigate the clinical effect of using lengthened trochanteric osteotomy wire fixation combined with autologous bone graft in patients undergoing revision total hip arthroplasty.

Methods: From December 2010 to December 2018,18 patients underwent revision of total hip arthroplasty with extended trochanteric osteotomy wire fixation and autogenous bone graft,including 8 males and 10 females with an average age of (78.89±3.32) years old ranging from 68 to 82 years. The time from the initial replacement to the revision was 9 to 22 (16.33±2.93) years. The patients were followed up regularly after operation. The healing time of osteotomy,the time of full weight-bearing activity,Harris score of hip joint and complications were recorded.

Results: All 18 patients were followed up for 16 to 38 months with an average of (25.78±6.65) months. The incision length was 16 to 21 cm with an average of (18.89±1.32) cm; the operation time was 105 to 128 min with an average of (115.44±6.59) min,the bleeding volume was 240 to 285 ml with an average of (267.44±13.77) ml. The healing time of osteotomy was 12 to 18 weeks with an average of (15.61±1.75) weeks. Harris score of hip joint was (47.11±5.04) before operation,(76.39±3.85) during full weight-bearing activities,and (82.22±2.76) at the final follow-up(P<0.05). During the follow-up period,there were no complications such as limb shortening,infection,poor incision healing,prosthesis loosening and sinking,and periprosthetic fracture.

Conclusion: In revision total hip arthroplasty,the use of extended trochanteric osteotomy wire fixation combined with autologous bone graft can achieve satisfactory clinical results,but the surgeon needs to make a systematic plan for the pre-revision,intraoperative and postoperative recovery.
KEY WORDS  Femur  Osteotomy  Bone transplantation  Bone wires  Arthroplasty,replacement,hip  Reoperation
 
引用本文,请按以下格式著录参考文献:
中文格式:唐慧斌,孙振国,翁伟,张占丰,杨红航.大转子延长截骨钢丝固定结合自体骨屑植骨在全髋关节翻修术中的应用[J].中国骨伤,2022,35(4):333~337
英文格式:TANG Hui-bin,SUN Zhen-guo,WENG Wei,ZHANG Zhan-feng,and YANG Hong-hang.Application of extended trochanter osteotomy wire fixation combined with autologous bone graft in revision of total hip arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):333~337
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