髋关节结核病灶清除术后关节僵硬的特点及治疗  

Clinical features and management of ankylosis after focus Debri'dement of tuberculosis of the hip

作　　者：张亮[1] 靳安民[1] 胡俊勇[1] 

机构地区：[1]第一军医大学珠江医院全军骨科中心,广东广州510282

出　　处：《中国骨伤》2001年第9期519-521,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨髋关节结核病灶清除术后关节僵硬的预防与治疗。方法　 2 0例髋关节结核病灶清除术后关节僵硬病人 ,首先给予全麻下手法松解 ,未达优良者经髋关节后外侧切口进入行软组织松解手术治疗 ,术后髋关节均屈曲位固定 3天 ,然后进行CPM功能锻炼及主动功能锻炼。结果　术后半年 2 0例髋关节屈曲均超过 90°,14例可达 12 0°。结论　全麻下行髋关节手法松解 ,或股骨髁上骨牵引加全麻下行髋关节手法松解 ,对大多数髋关节结核病灶清除术后关节僵硬的改善是十分有效的 ;少数严重病例 ,由髋关节后外侧切口进入行软组织松解术亦可取得满意效果。Objective To explore prevention and treatment methods of ankylosis after focal debri'dement of tuberculosis of the hip Methods 20 patients with ankylosis after focal debri'dement of tuberculosis of the hip were reviewed.All were treated with manipulation at first to release the contracture under general anesthesia;if there was no effect,release operation of soft tissues was performed through posteriolateral approach.After the operation,the hip joints were fixed at flexed position for 3 days followed by active exercise and CMP treatment.Results After a period follow-up of 6 months,the flexion angles of hip joint were more than 90° in 20 cases,even reached 120° in 14 cases.Conclusion This study showed that manual treatment to release muscular under general anesthesia,or combined with supracondylar skeletal traction of femur were very effective to improve articular function of patients with ankylosis after focal debri'dement of tuberculosis of the hip.In some patients with severe symptoms,release operation of soft tissues through posteriolateral approach also produced good effects.After operation,active exercise and CMP treatment are important.

关 键 词：髋关节 骨结核 关节强直 治疗 

分 类 号：R529.2[医药卫生—内科学]