人工全髋关节置换术治疗髋臼骨折继发创伤性关节炎近期疗效观察  

SHORT-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY FOR POST-TRAUMATIC OSTEOARTHRITIS SECONDARY TO ACETABULAR FRACTURE

作　　者：章军辉[1] 凌晶[1] 刘华[1] 陶昆[1] 曾志明[1] 章云峰[1] 何志勇[1] 狄正林[1] 冯建翔[1] 徐荣明[1] 

机构地区：[1]宁波市第六医院关节外科,浙江宁波315040

出　　处：《中国修复重建外科杂志》2013年第8期990-993,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨人工全髋关节置换术(total hip arthroplasty,THA)治疗髋臼骨折继发创伤性关节炎的近期疗效。方法回顾分析2004年1月-2012年3月,接受THA治疗的12例13髋髋臼骨折继发创伤性关节炎患者临床资料。其中男6例,女6例;年龄40～68岁,平均55.6岁。左髋5例,右髋6例;双髋1例。髋臼骨折至THA时间为12～240个月,平均65.7个月。术前髋关节Harris评分为(48.8±9.5)分。结果术后切口均Ⅰ期愈合,无下肢深静脉血栓形成、感染等并发症发生。术后10例10髋获随访,随访时间1～7年,平均4.8年。末次随访时Harris评分为(86.5±8.6)分,与术前比较差异有统计学意义(t=10.520,P=0.006)。X线片复查示,髋臼假体无不稳定发生,1髋股骨柄假体下沉2 mm,2髋发生假体周围骨溶解。2髋发生异位骨化,根据Brooker分级标准Ⅰ、Ⅱ级各1例。结论 THA治疗髋臼骨折继发创伤性关节炎可获满意近期疗效,其中术前严格适应证选择、病理评估与合适的髋臼重建方法是获得良好疗效的关键。Objective To discuss the short-term effectiveness of total hip arthroplasty（THA） for post-traumatic osteoarthritis secondary to acetabular fracture. Methods Between January 2004 and March 2012,the clinical data was analyzed retrospectively from 12 cases（13 hips） of post-traumatic osteoarthritis secondary to acetabular fracture undergoing THA.Of 12 patients,6 were male and 6 were female,with an average age of 55.6 years（range,40-68 years）.The locations were the left hip in 5 cases,the right hip in 6 cases,and bilateral hips in 1 case.The interval between acetabular fracture and THA was 65.7 months on average（range,12-240 months）.The preoperative hip Harris score was 48.8 ± 9.5. Results The incisions healed by first intention.No deep vein thrombosis and infection occurred postoperatively.Ten cases were followed up 1-7 years（mean,4.8 years）.The hip Harris score was 86.5 ± 8.6 at last follow-up,showing significant difference when compared with preoperative score（t=10.520,P=0.006）.X-ray films showed no acetabular prosthesis instability.Stem subsidence（2 mm） occurred in 1 case,peri-prosthetic osteolysis in 2 cases,and heterotopic ossification in 2 cases（Brooker type I and type II in 1 case,respectively）. Conclusion THA has satisfactory short-term effectiveness for post-traumatic osteoarthritis secondary to acetabular fracture.The good effectiveness is based on strict case selection,pathological evaluation,and the proper acetabular reconstruction.

关 键 词：人工全髋关节置换术 髋臼骨折 创伤性关节炎 

分 类 号：R687.4[医药卫生—骨科学]