全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎  

Total hip replacement in the treatment of traumatic arthritis after operation of acetabulum dislocation

作　　者：许鹏雍[1] 凌尚准[1] 梁广权[1] 梁善校[1] 

机构地区：[1]百色市人民医院,广西533000

出　　处：《创伤外科杂志》2015年第4期330-333,共4页Journal of Traumatic Surgery

摘　　要：目的：探讨全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎（ traumatic ostcoarthritis，TOA）的临床疗效。方法选择2009年3月～2013年3月我院收治的髋臼骨折脱位术后并发创伤性关节炎行全髋关节置换术的患者27例为研究对象，男性16例，女性11例；年龄32～57岁，平均（45．2±8．7）岁。对其临床资料进行回顾性分析，并于术前和术后分别评定髋关节功能，评价手术疗效。结果27例患者均顺利完成手术，所有患者术后切口均Ⅰ期愈合；术后Harris评分为76～92分，其中80分以上的患者25例，优良率达到92．6％，平均（89．1±5．78）分，与术前的（45．3±5．86）分相比，存在显著差异（P＜0．05）；关节屈曲、内收、外展、外旋及内旋与术前对比差异均有统计学意义（ P＜0．05），髋关节功能得到明显改善。结论髋臼骨折脱位术后易并发创伤性关节炎（TOA），采用全髋关节置换术治疗具有术后并发症少、髋部功能改善明显、临床效果好、患者满意度高等优点，值得临床推广应用。Objective To evaluate the clinical efficacy of total hip replacement in the treatment of traumat-ic ostcoarthritis （ TOA） after operation of acetabulum dislocation.Methods Twenty seven patients [16 males and 11 females aged from 32-57 years with an average age of （45.2 ±8.7） years] of acetabulum fracture from Mar.2009 to Mar.2013 in our hospital were performed total hip replacement for the treatment of TOA after operation of acetab-ulum dislocation were chosen and their clinical data was retrospectively analyzed.The preoperative and postopera-tive evaluation of hip function were performed and the effect of surgery was completed.Results All patients were successfully operated and all incisions achieved primary healing;postoperative Harris score was 76 to 92,of which 25 patients were more than 80 and the good and excellent rate was 92.6% with an average score of （ 89.1 ±5.78 ） . The difference was significant compared with the preoperative one of （45.3 ±5.86,P〈0.05）;the flexion,adduc-tion,abduction,external rotation and internal rotation of the joint were greatly different from those before operation with statistical significance（P〈0.05）.The hip function improved obviously.Conclusion Total hip replacement for the treatment of traumatic ostcoarthritis（ TOA） commonly seen after operation of acetabulum dislocation has less postoperative complications and achieves obvious improvement in hip function. It also has clinical advantages of good effect and high patient satisfaction,worthy of clinical popularization and application.

关 键 词：髋臼骨折 髋关节 置换 脱位 关节炎 

分 类 号：R683[医药卫生—骨科学]