改良打压植骨技术在股骨假体翻修术中的应用  

Design of intramendullary broacher with sliding hammer in revision hip replacement for failed femoral prosthesis and its clinical application

作　　者：刘好源[1] 黄哲元[1] 黄建明[1] 简国坚[1] 龚灏[1] 陈峰嵘[1] 徐天睿[1] 

机构地区：[1]解放军第174医院骨科,福建省厦门市361003

出　　处：《中国骨与关节损伤杂志》2013年第2期107-109,共3页Chinese Journal of Bone and Joint Injury

基　　金：南京军区医学科技创新课题(08MA070)

摘　　要：目的探讨人工髋关节置换术后股骨假体翻修手术中应用滑锤式髓腔锉进行打压植骨的临床疗效。方法利用自行设计的滑锤式髓腔锉完成对32例人工髋关节置换术后松动的股骨侧假体进行翻修,达到支撑性植骨夯实、成形。翻修术后采用Harris评分及X线观察进行临床疗效评定。结果 32例术后均获随访20-65个月,平均36个月。Harris评分从术前平均44分提高术后2年的90.4分,未出现假体松动及下沉。结论滑锤式髓腔锉在夯实植骨块的过程中使植骨床四周骨量均匀,能有效防止髋内、外翻及植骨块移向远端不需植骨的髓腔,操作简单,值得临床推广。Objective To design a set of the intramendullary broacher with sliding hammer which can be used in revision arthroplasty of the hip for failed femoral prosthesis and investigate its application. Methods The intramendullary broacher with sliding hammer composed of local stem, dissembled location stem handle, sliding broacher, broacher extension mantle, oriented pod of broacher, sliding hammer, fork-shape sliding hammer, etc. This set was used in thirty two femoral prosthesis revision. Harris hip scores and X-ray were used to evaluate the results. Results Thirty two patients were followed up for 20~ 65 months, with an average of 36 months. The mean Harris hip scores improved from 44 before operation to 90.4 two years after operation. No stem subsidence was found. Conclusion The intramendullary broacher with sliding hammer can impact bone graft to avoid prosthesis varus or valgus, prevent the distal egress of graft, gain simple manipulation. This set of appliance should be used widely with simple manipulation and satisfied clinical result.

关 键 词：髓腔锉 股骨假体 翻修术 打压植骨 

分 类 号：R687.34[医药卫生—骨科学]