全髋置换术在治疗成人髋臼发育不良伴股骨头坏死中的应用  

The Application of Total Hip Replacement in the Treatment of Adult Hip Dysplasia with Femoral Head Necrosis

作　　者：赵玉明[1] 唐晶[1] 赵爱兵[1] 冯桂友 张春城[1] 戴勇[1] 

机构地区：[1]泰兴市第三人民医院(骨伤专科医院),泰兴225400

出　　处：《基因组学与应用生物学》2016年第11期2971-2974,共4页Genomics and Applied Biology

摘　　要：探讨全髋置换术（THA）在治疗成人髋臼发育不良伴股骨头坏死中的临床应用。26例（29髋）施行全髋置换术治疗成人髋臼发育不良伴股骨头坏死，女性18例，男性8例，平均年龄55岁（39～62）。根据Crowe分类，Ⅰ型15例15髋，Ⅱ型7例8髋，Ⅲ型2例3髋，Ⅳ型2例3髋。髋臼缺损重建采用标准全髋置换术，自体骨植骨造盖和重建髋臼等方法。术前Harris髋关节功能评分平均49．1，下肢缩短2-4cm，平均2．5cm。随访26例（29髋），平均随访时间为3．5年（1．1-4．6）。随访期内未发现手术感染或神经、血管损伤、下肢深静脉血栓（DVT）等并发症。术后X线检查显示假体形态良好并且位置稳定，植骨块融合尚可。术后Harris评分平均86分。下肢短缩0-2．7cm，平均1．0cm。所有患者均疼痛明显缓解，步态显著改善，2例双下肢不等长仍超过2cm，轻微跛行。全髋关节置换术是治疗成人髋臼发育不良伴股骨头坏死的一种理想的方法，能有效重建患者髋臼功能。To explore the clinical application of total hip arthroplasty （THA） in the treatment of adults hip dysp- lasia with femoral head necrosis. 26 cases （29 hips） who suffered adult acetabular dysplasia with femoral head necrosis were treated by total hip replacement. There were 18 females and 8 males, the average age was 55 years （39-62）. According to Crowe classification, there were type I 15 cases （15 hips）, type II 7 cases （8 hips）, type III 2 cases （3 hips） and type IV 2 cases （3 hips）. To reconstruct acetabular defect used the methods which are standard total hip replacement surgery, autologous bone grafting and reconstruction acetabulum. Preoperative Harris hip score was 49.1, lower limb shortening 2-4 cm （average of 2.5 cm）. Follow-up of 26 cases （29 hips）, with an average follow-up time was 3.5 years （1.1 to 4.6）. During follow-up period there was no found surgery infection, nerve or vascular injury, deep vein thrombosis （DVT） and other complications. Postoperative X-ray examination showed good shape and location of the prosthesis, bone graft fusion good. Postoperative Harris hip score was 86 points, lower limb shortening 0-2.7 cm （average of 1.0 cm）. All patients had pain relief, significant improvement in gait. Two cases of leg length were still more than 2 cm, a slight limp. Total hip replacement is an ideal treatment of adult acetabular dysplasia with femoral head necrosis to effectively rebuild the patient＇s acetabulum function.

关 键 词：髋臼发育不良伴股骨头坏死 全髋置换术 髋臼重建 

分 类 号：R687.4[医药卫生—骨科学]