同侧髋臼骨折合并股骨颈骨折行一期全髋关节置换术的临床研究  

Acetabular fracture with ipsilateral neck fracture treated by total hip arthroplasty

作　　者：周建生[1] 王志岩[1] 张长春[1] 周新社[1] 肖玉周[1] 

机构地区：[1]安徽蚌埠医学院附属医院骨科,233004

出　　处：《中华关节外科杂志（电子版）》2009年第1期25-27,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨同侧髋臼骨折合并股骨颈骨折行一期全髋关节置换(THA)的手术方法及其疗效。方法2003年7月至2006年3月,对5例同侧髋臼骨折合并股骨颈骨折的患者行一期THA,均采用生物型人工髋关节,强调髋臼重建结构的稳定性,随访21～54个月(平均34.4个月);手术距受伤时间5～42d(平均18.6d)。3例2周内手术者,尽可能解剖复位内固定,2例超过4周手术者,在骨折畸形愈合的基础上,不剥离骨痂,给予结构性植骨并重塑髋臼。结果按HHS评分为87.6分,其中优2例,良2例,可1例,随访期间未发生感染、松动和异位骨化等并发症。结论对同侧髋臼骨折合并股骨颈骨折的患者行一期THA,能取得较好疗效,避免切开复位内固定引起的治疗周期长,高并发症,疗效差,甚至短期再次行THA等缺点;重视髋臼结构的稳定性和有翻修经验的医师参与是提高手术疗效的关键。Objective To evaluate the curative effect of acetabular fracture with ipsilateral neck fracture treated by total hip arthroplasty. Methods An analysis was done on five patients with acetabular fracture with ipsilateral neck fracture treated by total hip arthroplasty by cementless hip prosthesis and emphasizing the stability of rebuilded configuration of acetabulum. 3 cases were operated within 3 weeks which need anatomical reduction and strongly internal fixation. 2 cases were operated beyond 4 weeks, which were performed structural bone transplantation and reconstructed acetabulum. The follow up lasted for 21 -54 months （mean 34. 4 months） from July 2003 to March 2006. The preoperative time was 5 -42 days （ mean 14. 6 days）. Results Of all the cases, the harris hip score was 87. 6 points which included 2 excellent, 2 good and 1 fair. No infection, loose and heterotopic ossification were found in these cases. Conclusions The good curative effect with acetabular fracture with ipsilateral neck fracture can be obtained by total hip arthroplasty which can avoid the disadvantage of long period of cure, high complication rate, bad curative effect and making total hip arthroplasty again in short period caused by open reduction and internal fixation. It is key point for the operative effect to pay attention to the stability of the acetabular configuration and is involved in experienced doctors.

关 键 词：髋臼 股骨颈骨折 关节成形术 置换 髋 

分 类 号：R687.3[医药卫生—骨科学]