人工全髋关节置换术后脱位的原因及其防治  

Cause and control measures of postoperetive dislocation af ter tto al hip arthroplasty

作　　者：段军[1] 李锋生[2] 

机构地区：[1]暨南大学,广东广州510632 [2]广州市红十字会医院,广东广州510632

出　　处：《中国伤残医学》2015年第8期2-3,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨人工全髋关节置换术后假体脱位的原因及其防治措施。方法：收集2004年1月～2014年1月在我院行全髋关节置换的病人资料，总共408人4，48髋，男211人，234髋，女197人，214髋。其中脱位15例，男7例，女8例。对其进行回顾性分析，探讨脱位的影响因素及其治疗原则。结果：全髋关节置换术后脱位15例，脱位率3．3％；其中前脱位5例，后脱位10例；全髋关节置换术后翻修25例，脱位3例，脱位率12％；1例病人有精神病史，4例病人既往有髋部手术史，6例病人假体位置不佳或髋臼周围骨赘较多，4例病人术后有深蹲或翘二郎腿动作。15例患者脱位后均予以麻醉下手法复位，卧床皮肤牵引6周，其中10例复位成功，1例半年后再次脱位。5例予以手术切开复位或者调整假体位置，术后患者功能均恢复良好。结论：人工髋关节术后假体脱位有多种影响因素，大致可以从3方面考虑：（1）病人的状态；（2）医生的因素；（3）假体的设计。当然，有时这几方面是可以同时存在的。因此，只有全面了解病人脱位的原因，有针对性的治疗时，才能取得较好的效果。Objective：To analyze and prevent postoperative dislocation after total hip arthroplasty.Methods：408 patients （448hips） were collected from Jan 2004 to Jan 2014,which involved males 211（234 hips）,female 197 （214 hips）.There were 15 patients developed into dislocation.The influence and therapeutic principle of the dislocation were discussed through retrospective investigation.Results：There were 15 cases had dislocation,the rate was 3.3%,5 cases were anterior dislocation ,10 cases were posterior dislocation.25 patients were revision cases, among them 3 cases developed into dislocation, the rate was 12%.One case had mental disease;Four patients once had hip surgery;Six cases the position of prosthesis were not beautifull or some osteophyte around the acetabulum;Four cases of patients with postoperative squats or other action.All of the 15 cases were manual reduction in anesthesia, with skin traction 6 weeks.Ten cases were sucess;One case dislocate after 6 month;5 cases had to surgery, function of postoperative patients all recovered well.Conclusion：There were many factors influencing the postoperative dislocation after THA, which include the three points： the patient＇s condition, the doctor＇s factors, the design of the prosthesis.Of course, Sometimes these aspects could be all exist.Therefore, we could achieve better effect only through a comprehensive understanding the cause of the patients with dislocation.

关 键 词：人工全髋关节置换 脱位 治疗与预防 

分 类 号：R687.4[医药卫生—骨科学]