| 初次全髋置换术中髋臼骨折的分析与处理 |
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Received:August 26, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 何志勇 |
HE Zhi-yong |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Joint Surgery Department,Ningbo 6th Hospital,Ningbo 315040,Zhejiang,China |
hezymd@21cn.com |
| 狄正林 |
DI Zheng-ling |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Joint Surgery Department,Ningbo 6th Hospital,Ningbo 315040,Zhejiang,China |
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| 章军辉 |
ZHANG Jun-hui |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Joint Surgery Department,Ningbo 6th Hospital,Ningbo 315040,Zhejiang,China |
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| 冯建翔 |
FENG Jian-xiang |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Joint Surgery Department,Ningbo 6th Hospital,Ningbo 315040,Zhejiang,China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院关节外科, 浙江 宁波 315040 |
Joint Surgery Department,Ningbo 6th Hospital,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年22卷，第2期，第81-83页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：分析初次全髋置换术(pTHR)中髋臼骨折的原因和治疗结果，探讨预防和治疗方法。
方法：2004年7月至2006年12月，326例pTHR病历记载中11例术中出现髋臼骨折，女7例，男4例；年龄37～71岁，平均54岁。分析骨折原因、解剖位置、治疗方法和结果，对髋臼假体进行分类，评估导致骨折的风险因素。
结果：11例中，6例为打压安装髋臼假体时发生，3例是磨钻髋臼时发生，2例是安放Homman拉钩时发生。包括5例中央型骨折，3例为后方(后壁),2例为前方，1例为后上方。9例获得随访，随访时间12～29个月，平均18个月，无异位骨化，无脱位和深静脉栓塞，所有的骨折均愈合。
结论：髋臼骨折在非骨水泥型全髋置换术中并非罕见，需要重视。但在对髋臼假体进行牢固固定，获得初始稳定性后仍可获得骨长入，近期治疗结果良好。 |
| [关键词]:关节成形术,置换,髋 髋臼 骨折 |
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| Strategy of prevention and management of intraoperative fractures of acetabulum during primary total hip arthroplasty |
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Abstract:
Objective: To analyse the causes and resultes of intraoperative occurrence of an acetabular fracture in primary total hip arthroplasty and discuss propriate prevention and treatment of this problem.
Methods: Between July 2004 and December 2006,326 primary total hip arthroplasties were retrospectively reviewed and found that eleven patients(eleven hips) had sustained an intraoperative acetabular fracture involving 7 male and 4 female,aged from 37 to 71 years(mean 54 years). Analyzed the causes of fractures,the anatomic location,treatment and outcome of the fractures. Acetabular component designs were categorized and each design was analyzed for fracture risk.
Results: Among 11 cases,the fractures occurrenced as setting the prosthesis in 6 cases, grinding and drilling in 3 cases,drawning hook in 2 cases. There were 5 cases of central type fracture,3 of posterior-wall,2 of anterior,1 of posterior-upper. Nine of these patients(nine hips) had been followed-up for 12 to 29 months(mean 18 months). There were no heterotopic ossification, no dislocation,no deep venous embolism. All fractures were healing.
Conclusion: Acetabular fracture during primary total hip arthroplasty is a complication of acetabular fixation without cement,which should be think highly of. In the present series,retention of a stable cup is associated with uneventful osseous in growth and excellent early-term outcomes. |
| KEYWORDS:Arthroplasty,replacement,hip Acetabulum Fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 何志勇,狄正林,章军辉,冯建翔,徐荣明.初次全髋置换术中髋臼骨折的分析与处理[J].中国骨伤,2009,22(2):81~83 |
| 英文格式: | HE Zhi-yong,DI Zheng-ling,ZHANG Jun-hui,FENG Jian-xiang,XU Rong-ming.Strategy of prevention and management of intraoperative fractures of acetabulum during primary total hip arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(2):81~83 |
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