髋臼有限加深法THA治疗成人股骨颈骨折、严重股骨头缺血性坏死及髋关节骨性关节炎  

Acetabular finite deepening in total hip replacement for treatment of adult femoral neck fractures and severe ischemic necrosis of femoral head and hip osteoarthritis

作　　者：汤长华[1] 王黎明[2] 张晓慧[1] 周晓宇[1] 赵曙[1] 张杰[1] 纪兆亮[1] 冯国新[1] 李志胜[1] 朱冬承[1] 

机构地区：[1]泗洪县人民医院骨科,江苏宿迁223900 [2]南京医科大学附属南京第一医院骨科

出　　处：《中国骨与关节损伤杂志》2015年第4期337-339,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金(81171745)

摘　　要：目的探讨髋臼有限加深法全髋关节置换术（THA）结合软组织松解、骨创治疗仪治疗成人股骨颈骨折、严重股骨头缺血性坏死及髋关节骨性关节炎的近期疗效。方法回顾性分析自2007-01—2013-06采用髋臼有限加深、非骨水泥假体THA结合软组织松解、骨创治疗仪治疗20例股骨颈骨折、6例严重股骨头缺血性坏死塌陷并髋关节骨性关节炎、12例髋关节骨性关节炎的临床资料。结果本组术中出血量50~300 ml,平均120 ml;手术时间100~180 min,平均120 min。2例术后1个月出现患肢深静脉血栓形成,经溶栓、抗凝等治疗痊愈。术后38例均获得平均2.5（0.5~5）年随访,所有患者均无假体松动、脱位、感染并发症发生。双下肢基本等长,患髋疼痛完全消失,关节活动功能满意。髋关节功能Harris评分由术前（15.16±1.12）分恢复至末次随访时（92.42±1.08）分。结论髋臼有限加深法THA结合软组织松解、骨创治疗仪治疗成人股骨颈骨折、股骨头缺血性坏死、髋关节骨性关节炎明显提高了髋臼假体的稳定性,可预防髋臼包容不佳导致髋臼假体不稳,近期疗效优良。Objective To explore the recent curative effect of total hip arthroplasty（THA） combined with acetabular finite deepening, soft tissue release, bone wound therapy in the treatment of adult femoral neck fractures and severe ischemic necrosis of the femoral head and hip osteoarthritis. Methods A retrospective study was conducted for the acetabular finite deepening, non bone cement prosthesis THA combined with soft tissue release, bone wound therapy in the treatment of the clinical data of 20 cases of femoral neck fracture, 6 cases of severe ischemic necrosis of the femoral head collapse and osteoarthritis of the hip, 12 cases of osteoarthritis of the hip from January 2007 to June 2013. Results In this group, the amount of intraoperative bleeding was 50 to 300 ml, average 120 ml; operation time 100-180 min, average 120 min. The limb deep vein thrombosis occurred in 2 cases 1 month after the operation, and cured through thrombolysis, anticoagulation. After operation, 38 cases were followed up for averaged 2.5（0.5-5） years, all patients had no prosthesis loosening, dislocation,infection complications. Double lower limbs were basically equal in length, hip pain completely disappeared, the joint function maintained satisfactory. Harris hip joint function score improved from preoperative（15.16 ±1.12）points to（92.42±1.08）points at the end of the follow-up. Conclusion The acetabular finite deepening in THA combined with soft tissue release, bone wound therapy for the treatment of adult femoral neck fracture, ischemic necrosis of femoral head, hip osteoarthritis can improve the stability of the acetabular component significantly, prevent the poor acetabulum containment and acetabular prosthesis instability, achieve the recent good curative effect.

关 键 词：全髋关节置换术 髋臼有限加深 股骨颈骨折 股骨头缺血性坏死 髋关节骨性关节炎 骨创治疗仪 

分 类 号：R687.42[医药卫生—骨科学]