头颈实测法在人工股骨头置换术中的应用  

Advantage of actual femoral head-neck measurement in limb-length equalization in the hip hemi- arthroplasty

作　　者：杨辉[1] 唐三元[1] 李远辉[1] 向阳[1] 詹鹏[1] 柬志勇 

机构地区：[1]暨南大学第三附属医院 （珠海市人民医院）创伤骨科,广东省珠海市519000

出　　处：《中华创伤骨科杂志》2012年第7期587-590,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨头颈实测法在人工股骨头置换术中控制肢体K度的作用。方法吲顾性分析2008年1月至2010年7月应用头颈实测法进行的人工股骨头置换术患者资料（实测组）．共30例，男9例，女21例；平均年龄为71．2岁。以2003年7月至2007年10月应用经验方法治疗的60例人工股骨头置换术患苦为对照组，男17例，女43例；平均年龄68．5岁。比较两组患皙术后X线片测量双下肢长度差异和髋关节Harris评分结果。结果实测组术后双下胺长短差异：优（0～5mm）21例，良（6～10mm）7例，可（11～15mm）2例，优良率为93．3％；对照组优19例，良30例，町9例，差（〉15mm）2例，优良率为82．5％，两组比较差异有统计学意义（，=8．350，P=0．008）。实洲组30例患者中27例术后获12～24个月（甲均15．3个月）随访，对照组60例患者中56例术后获13～35个月（平均20．5个月）随访。末次随访时按髋关节功能Harris评分评定患髋功能：实测组优20例，良5例，可2例，优良牢为91．7％；对照组优29例，良18例，可7例，差2例，优良率为83．9％，两组比较差异有统计学意义（x^2=6．451，P=0．017）。结论头颈实测法在术中可以比较准确地控制人工股骨头置换后的肢体长度，是一种简便、可靠的方法。Objective To probe the advantage of actual femoral head-neck measurement in limb-length equalization in the hip hemiarthroplasty. Methods From Janual＇y 2008 to July 2010, 30 cases received actual femoral head-neck measurement in hip hemiarthroplasty. They were 9 males amt 21 females, 71.2 years of age on average. The matched control group included 60 cases receiving conventional hip hemiarthroplasty fi＇om July 2003 to October 2007. They were 17 males and 43 females, 68.5 years of age on average. The actual femoral head-neck measurement was used to decide the size of implant during the operation. The 2 groups were compared in terms of the reduced length of the affected limb on the preoperative X-ray film, the length discrepancy on the postoperative X-ray film and hip Harris score. Results In the actual measurement group, there were 21 excellen! cases regarding length discrepancy （within 5 mm）, 7 good cases （6 to 10 mm） and 2 fair cases （11 to 15 ram）, with an excellent to good rate of 93.3%, while in the control group there were 19 excellent cases, 30 good cases, 9 fair cases and 2 bad cases （over 15 mm）. with an excellent to good rate af 82.5%. The difference between the 2 groups was statistically significant （X2 = 8. 350, P = 0. 008） . Twenty-seven cases in the actual measurement group obtained an average follow-up of 15.3 months （from 12 to 24 months） while 56 eases in the control group obtained an average tollow-up of 20. 5 months （from 13 to 35 months）. In terms of the hip Harris score at the last follow-up, the actual measurement group had 20 excellent cases, 5 good cases and 2 fair cases while the control group had 29 excellent cases, 18 good cases, 7 fair cases and 2 bad cases. There was a significant difference regarding the excellent to good rate （91.7% versus 83.9%） between the 2 groups （x2=6.451, P=0.017） . Conclusion In the hip hemiarthroplasty, the actual femoral head-neck measurement is a simple but reliable method to control the length discrepancy nmre accura

关 键 词：关节成形术 置换 髋 下肢 研究设计 

分 类 号：R687.3[医药卫生—骨科学]