全髋翻修术下肢不等长的原因分析及处理  

Hip Revision with Lower Limb Length Discrepancy:Causes and Treatment

作　　者：徐海军[1] 程文俊[1] 王俊文[1] 郑琼[1] 勘武生[1] 

机构地区：[1]华中科技大学同济医学院附属武汉市普爱医院骨科,湖北武汉430032

出　　处：《武汉大学学报（医学版）》2015年第3期440-443,共4页Medical Journal of Wuhan University

摘　　要：目的:分析髋关节翻修病例中下肢不等长发生的原因,评估翻修手术后肢体不等长平衡的效果。方法:36例(36髋)进行髋关节翻修的患者存在肢体不等长,测量下肢长度差异,评估髋臼假体和股骨假体的位置,随访患者术后疗效。结果:最低随访12个月,平均随访26.7(12-55)月。术前Harris评分38.6±39.1,术后Harris评分平均为83.3±26.4,肢体长度差异:术前平均肢体长度差异2.35(-3.8-2)cm,术后平均肢体长度差异0.65(-2-1)cm。髋臼侧原因导致肢体不等长12例,股骨侧原因导致肢体不等长20例,关节间隙造成肢体短缩8例,股骨侧及髋臼侧差异均存在的患者为2例。结论:翻修术前仔细分析下肢不等长的来源,设计合理的手术方案,选择合适的假体可以尽量减少肢体长度差异。Objective：To evaluate the outcomes of revision hip surgery with limb-length discrepancy.Methods：We retrospectively reviewed the clinical and radiographic records of patients who had undergone revision hip surgery at our institution with limb-length discrepancy,and identified 36patients（36hips）.Limb length discrepancy and Harris score were evaluated.Results：The average duration of follow-up was 26.7months（12-55months）.The mean Harris scores preoperatively were 38.6±39.1,and 83.3±26.4postoperatively.The mean limb length discrepancy preoperatively was 2.35cm（-3.8-2cm）,and 0.65cm（-2-1cm）postoperatively.Limb length discrepancy with 12 hips came from acetabular side,20 hips from femoral side,8patients from joint space,two cases from both acetabular and femoral side.Conclusion：Careful evaluation of position and orientation of the components of patients with limb-length discrepancy following hip arthroplastymay could reveal the cause of the discrepancy,and then prevent it.

关 键 词：髋关节翻修 下肢不等长 人全髋关节置换 

分 类 号：R687.4[医药卫生—骨科学]