髋臼骨折延期人工髋关节置换术的临床观察  

Clinical observation of delayed artificial hip replacement for acetabular fracture

作　　者：邹宏[1] 陈玉龙[1] 弋石泉[1] 王辉[1] 沈建平[1] 杨帆[1] 谢成[1] 殷勇[1] 冯国斌[1] 

机构地区：[1]绵阳市骨科医院关节外科,四川绵阳621000

出　　处：《四川医学》2013年第5期689-692,共4页Sichuan Medical Journal

摘　　要：目的探讨延期髋关节置换术在髋臼骨折治疗中的应用。方法自2000年6月～2011年5月对14例年龄36～68岁的髋臼骨折患者行人工关节置换,其中6例为未予治疗的髋臼陈旧性骨折,8例为内固定术后失败的患者,受伤至关节置换手术时间6～36个月,原始髋臼骨折按Judet-Letournel分型,A1型8例,A2型4例,C1型2例。术中发现均存在髋臼不同程度骨缺损,按AAOS分型,IA型12例,III型2例。结果本组患者均顺利完成手术,手术时间120～170min,平均150min,输血800～1500ml,平均1200ml。术后无切口感染、血肿等并发症。下床时间2～5d,平均3d。住院时间14～27d,平均19.3d。14例患者有随访结果,随访时间2～60个月,末次随访无假体松动。按Harris评分标准:优13例,良1例。结论延期人工髋关节置换术治疗髋臼骨折主要针对早期未规范治疗和手术治疗失败的患者,通常患者骨折会有部分愈合,存在部分位置骨缺损,头臼关系不匹配,继发创伤性关节炎。髋臼骨折行人工髋关节置换术与髋关节翻修有较大相似性,充分的术前准备非常必要,近期治疗效果优良。Objective To study the application of delayed artificial hip replacement to acetabular fracture.Methods From June 2000 to May 2011,artificial hip replacements were performed in our department for 14 acetabular fracture patients aged from 36 to 38 years old.Among all the cases,6 were old acetabular fracture which had never been treated.8 were these patients whose operation time had been postponed for 6～36months since their injury after the failure of internal fixation of their acetabular fractures.According to Letournel-Judet system,these cases were classified as type A1 in 8,type A2 in 4 and type C1 in 2.Results All cases had a successful operation which lasted for 120~170min with average time of 150min.There was none of the complications such as cut infection and hematoma.14 patients had follow-up results whose follow-up time was from 2-60months.There was no sign of prosthesis loosing for the last follow-up.Conclusion Delayed artificial hip replacement for acetabular fracture is mainly directed against these cases without standardized treatment at early stage and operation treatment failure.Artificial hip replacement for acetabular fracture and hip revision have great similarity.The clinical outcome of artificial hip replacement after treatment failure of acetabular fracture is satisfactory,so it is a good alternative method for non-standardized treatment and operation treatment failure of acetabular fracture,but full preoperative preparation is very necessary.

关 键 词：关节成形术 髋臼骨折 全髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]