| 髋关节置换术治疗髋臼骨折继发创伤性关节炎的临床观察 |
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Received:May 29, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 余汪洋 |
YU Wang-yang |
山东中医药大学, 山东 济南 250014 |
Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China |
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| 吴伟山 |
WU Wei-shan |
山东中医药大学附属医院关节肿瘤科, 山东 济南 250014 |
Department of Joint Oncilogy Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China |
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| 石业飞 |
SHI Ye-fei |
山东中医药大学, 山东 济南 250014 |
Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China |
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| 尹纪光 |
YIN Ji-guang |
山东中医药大学附属医院关节肿瘤科, 山东 济南 250014 |
Department of Joint Oncilogy Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China |
yjg070715@163.com |
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| 期刊信息：《中国骨伤》2024年37卷，第1期，第86-91页 |
| DOI：10.12200/j.issn.1003-0034.20221306 |
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目的:深入研究全髋关节置换术(total hip arthroplasty,THA)治疗髋臼骨折继发创伤性关节炎的临床疗效。
方法:回顾性分析2019年10月至2022年6月,采用THA治疗15例髋臼骨折继发创伤性关节炎患者,男8例,女7例,年龄40~76(59.20±9.46)岁。记录术前及术后假体松动、髋关节脱位、髋关节活动度、神经损伤等情况,采用Harris评分、视觉模拟评分(visual analogue scale,VAS)、影像学检查评价髋关节功能及手术疗效。
结果:15例均顺利完成手术,术中无神经、血管损伤,术后切口均Ⅰ期甲级愈合,无感染。随访时间6~39(18.33±9.27)个月。其中1例术后半年发生髋臼侧假体松动,经过翻修手术后恢复良好;1例髋关节脱位,经切开复位处理后治愈,无不良后果。术后末次随访Harris评分(88.60±4.01)分,与术前(47.20±11.77)分相比,差异有统计学意义(P<0.05)。术后末次随访VAS评分1(1)分,与术前8(2)分相比,差异有统计学意义(P<0.05)。末次随访时,本组所有患者疼痛症状减轻或消失,关节功能满意;末次随访影像学资料显示关节假体贴合良好,无异位骨化发生,假体无松动。
结论:THA治疗髋臼骨折继发创伤性关节炎疗效可靠,能有效提高患者的生活质量。术前对患者全面评估、骨缺损评估,术中髋臼、股骨、内固定物与骨缺损的处理是手术成功的关键因素。 |
| [关键词]:髋臼骨折 创伤性关节炎 内固定 髋臼骨缺损 全髋关节置换术 |
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| Retrospective clinical study of hip replacement in the treatment of traumatic arthritis secondary to acetabular fracture |
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Abstract:
Objective To investigate the clinical effect of total hip replacement (THA) in the treatment of traumatic arthritis secondary to acetabular fracture.
Methods From October 2019 to June 2022,15 patients with secondary traumatic arthritis of acetabulum fracture were treated with THA. There were 8 males and 7 females,aged from 40 to 76 years old with an average of (59.20±9.46) years old. Prosthesis loosening,dislocation of hip joint,range of motion of hip joint,nerve injury and other conditions were recorded before and after surgery. Harris score,visual analogue scale (VAS) and imaging were used to evaluate hip joint function and surgical effect.
Results Follow-up time ranged 6 to 39 months with an average of (18.33±9.27) months. All the 15 patients successfully completed the operation,no nerve and blood vessel injury during the operation,postoperative wound healing was stageⅠ,no infection,one case of acetabular side prosthesis loosening at half a year after operation,and recovered well after revision surgery,one case of hip dislocation was cured after open reduction treatment,no adverse consequences. Harris score at the last postoperative follow-up was (88.60±4.01) points,compared with the preoperative (47.20±11.77) points,the difference was statistically significant (P<0.05),and VAS at the lateat postoperative follow-up was 1 (1) points,compared with the preoperative 8 (2) points,the difference was statistically significant (P<0.05). At the last follow-up,the pain symptoms were relieved or disappeared,and the joint function was satisfactory. The imaging data of the latest follow-up showed joint was well pseudoradiated,no abnormal ossification occurred,and the prosthesis was not loose.
Conclusion THA is effective in the treatment of traumatic arthritis secondary to acetabular fracture and can effectively improve the quality of life of patients. Preoperative comprehensive evaluation and bone defect evaluation of patients,and intraoperative management of acetabulum,femur,internal fixation and bone defect are key factors for the success of surgery. |
| KEYWORDS:Acetabular fracture Traumatic arthritis Internal fixation Acetabular bone defect Total hip arthroplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 余汪洋,吴伟山,石业飞,尹纪光.髋关节置换术治疗髋臼骨折继发创伤性关节炎的临床观察[J].中国骨伤,2024,37(1):86~91 |
| 英文格式: | YU Wang-yang,WU Wei-shan,SHI Ye-fei,YIN Ji-guang.Retrospective clinical study of hip replacement in the treatment of traumatic arthritis secondary to acetabular fracture[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(1):86~91 |
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