人工全髋关节置换术后早期假体脱位的原因及防治措施  

Study on the Causes and Preventions of Early Dislocation in Primary Total Hip Arthroplasty

作　　者：李永奖[1] 张力成[1] 杨国敬[1] 蔡春元[1] 汤呈宣[1] 林利兴[1] 

机构地区：[1]温州医学院附属第三医院骨科,浙江瑞安325200

出　　处：《中国中医骨伤科杂志》2007年第2期1-3,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：浙江省医药卫生科学研究基金(2006B123);瑞安市科委课题(20052093)

摘　　要：目的:分析初次人工全髋关节置换术后早期假体脱位原因,并探讨其防治措施。方法:随访研究29例(29髋)首次THA后早期发生脱位的原因、处理及结果;并针对脱位原因分别提出相应的预防措施。结果:29例患者中,软组织张力异常17例;假体位置不良6例;假体位置不良伴软组织张力异常1例;患者活动范围超过安全范围5例。其中15例经手法复位后未再出现脱位,7例手法复位失败或再脱位行切开复位。闭合复位或开放复位后外展中立位牵引,大多数早期能获得成功。结论:分析初次人工全髋关节置换术后早期假体脱位原因,并探讨其防治措施。Objective：To analyze the causes of early dislocation after primary total hip arthroplasty and to explore its preventions and treatments. Methods：The clinical materials of dislocation after THA were reviewed in 29 cases129 hips）. The strength of their hip abductor musculature was tested. Radiographs （AP view） of their pelvises were measured. Results： There were 17 cases of abnormal soft--tissue tension, 6 cases of malposition, 1 case of malposition and abnormal soft--tissue tension and 5 cases of over motion. Close reduction was succeeded in 15 cases,7 cases failed to close reduction for which surgical treatment was recommended： Immediate closed reduction or open reduction with cast initially could be successful in most cases. Conclusion：Low soft tissue tension, especially the weakness of abductor musculature was the most important cause of dislocation after THA. With the correct orientation of components and an enhanced capsulotendinous repair, the posterolateral approach can result in an extremenly low early dislocation rate.

关 键 词：全髋置换术 早期脱位 关节囊修补 预防 

分 类 号：R318.17[医药卫生—生物医学工程]