| 全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良患者及围手术期并发症分析 |
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Received:August 22, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李建有 |
LI Jian-you |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
ljywn1977@126.com |
| 管国华 |
GUAN Guo-hua |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
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| 李雄峰 |
LI Xiong-feng |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
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| 黄胜 |
HUANG Sheng |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
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| 吴猛 |
WU Meng |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
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| 高宏梁 |
GAO Hong-liang |
湖州师范学院附属湖州中心医院骨科,浙江 湖州 313000 |
Department of Orthopaedics, Huzhou Central Affiliated Hospital of Huzhou Teachertraining College, Huzhou 313000, Zhejiang, China |
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| 孙俊英 |
SUN Jun-ying |
苏州大学附属第一医院骨科 |
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| 期刊信息：《中国骨伤》2012年25卷，第1期，第74-77页 |
| DOI：10.3969/j.issn.1003-0034.2012.01.021 |
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目的：探讨人工全髋关节置换术治疗Crowe Ⅳ型成人髋关节发育不良的疗效及围手术期并发症。
方法：2000年3月至2010年3月,对19例(23髋) Crowe Ⅳ型成人髋关节发育不良患者进行人工全髋关节置换术,其中男5例,女14例；年龄41～72岁,平均61.3岁。髋臼侧采用小臼杯结合髋臼内陷技术安置臼杯假体,股骨侧采用粗隆下短缩截骨放置股骨假体。采用Harris评分评价术后髋关节功能。
结果：所有患者获随访,时间1～8年,平均4.2年,术后X线片显示髋臼假体均位于真臼内,无髋臼假体松动。股骨侧截骨处均骨性愈合。Harris评分由术前平均(34.0±6.9)分提高至末次随访的(85.0±7.5)分。发生围手术期并发症11例,包括股骨劈裂骨折 3例,神经并发症 3例,截骨延迟愈合 2例,术后脱位 3例。
结论：采用小臼杯、假体内陷技术、股骨短缩截骨对Crowe Ⅳ型DDH患者行全髋关节置换可以重建关节功能,恢复下肢长度,早期疗效满意,但并发症发生率高。后期疗效有待进一步观察。 |
| [关键词]:关节成形术 置换 髋 截骨术 围手术期并发症 |
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| Analysis of perioperation complications of total hip arthroplasty in treating Crowe type Ⅳ developmental dysplasia of the hip |
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Abstract:
Objective: To evaluate the clinical effects of total hip arthroplasty(THA) for Crowe type Ⅳ developmental dysplasia of the hip(DDH) and analyze perioperative complications.
Methods: From March 2000 to March 2010,19 patients (23 hips,of them,4 patients with bilateral hips) with Crowe type Ⅳ DDH underwent THA. There were 5 males and 14 females,with average age of 61.3 years(ranged,41 to 72 years). All hips were treated with small acetabular components combined with medial protrusion technique in acetabular reconstruction,as well as subtrochanteric shortening osteotomy in femur. Joint function of hips were evaluated according to Harris scoring.
Results: All patients were followed up with an average of 4.2 years (ranged,1 to 8 years). Postoperative X-ray films showed all acetabular prosthesis were in true acetabulum. No loosening and nonunion were found in all patients. Harris scoring improved from preoperative 34.0±6.9 to postoperative 85.0±7.5. Complications occurred in 11 cases in the patients,including femoral split fracture in 3 cases,nerve injury in 3 cases,delayed union in 2 cases,dislocation in 3 cases.
Conclusion: Total hip arthroplasty using small acetabular component,medial protrusion,femoral subtrochanteric shortening osteotomy technique for the Crowe type Ⅳ DDH can effectively restore hip function and leg length. But incidence of complications is high. The long-term follow-up is necessary for further study. |
| KEYWORDS:Arthroplasty replacement hip Osteotomy Peroperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李建有,管国华,李雄峰,黄胜,吴猛,高宏梁,孙俊英.全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良患者及围手术期并发症分析[J].中国骨伤,2012,25(1):74~77 |
| 英文格式: | LI Jian-you,GUAN Guo-hua,LI Xiong-feng,HUANG Sheng,WU Meng,GAO Hong-liang,SUN Jun-ying.Analysis of perioperation complications of total hip arthroplasty in treating Crowe type Ⅳ developmental dysplasia of the hip[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(1):74~77 |
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