全髋关节置换治疗髋臼骨折术后关节病变  

Total hip arthroplasty for hip arthropathies secondary to acetabular fracture

作　　者：殷勇[1] 薛志强[1] 尹乾斌 王恒[1] 谢成[1] 弋石泉[1] 杨静[2] YIN Yong;XUE Zhi-qiang;YIN Qian-bin;WANG Heng;XIE Cheng;YI Shi-quan;YANG Jing(Department of Hip Surgery,Orthopaedic Hospital of Mianyang,Mianyang 621000,China;Orthopedic Department,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]绵阳市骨科医院髋关节科,四川绵阳市621000 [2]四川大学华西医院骨科,四川成都市610041

出　　处：《中国矫形外科杂志》2018年第15期1355-1359,共5页Orthopedic Journal of China

摘　　要：[目的]探讨全髋关节置换治疗髋臼骨折术后继发创伤性关节炎及股骨头坏死疗效。[方法]2005年3月~2014年5月19例髋臼骨折术后继发创伤性关节炎和股骨头坏死患者行全髋关节置换术,其中男7例,女12例;年龄43~67岁,平均(55.82±8.63)岁。观察记录患者术前和术后临床症状、Harris评分及X线片表现。[结果]19例患者均顺利完成手术,1例发生坐骨神经损伤,经过针灸及口服甲钴胺半年后恢复。此外,术后发生3例肌间静脉血栓形成,1例感染和1例脱位,经相应处理,均治愈,无不良后果。所有患者随访3~8年,平均(4.13±1.06)年。所有患者髋关节功能获得明显改善,疼痛缓解,Harris评分由术前(41.65±17.58)分,显著增加至末次随访时(89.56±3.75)分,差异有统计学意义(P<0.05)。随访过程中X线检查未发现假体周围骨溶解及松动。[结论]全髋关节置换是治疗髋臼骨折术后继发创伤性关节炎及股骨头坏死的有效方法。Objective traumatic arthritis and femoral head necrosis secondary to acetabular fracture. [Method] From March 2005 to May 2014, 19 patients underwent THA for traumatic arthritis and femoral head necrosis secondary to acetabular fracture previously treated with open reduction and internal fixation. Of them, 7 males and 12 females aged from 43 to 76 years with an average of（55.82±8.63）years. The clinical symptoms and signs, Harris scores, as well as radiographic presentations were assayed. [Result] All the 19 patients had operation performed successfully, although 1 patient got sciatic nerve injury which completely recovered 6 months late with oral administration of mecobalamin. Besides, 3 patients were of intermuscular venous thrombosis, 1 of deep infection perioperatively and 1 of dislocation 6 months late, all of the 5 patients were fully cured with proper treatment without adverse consequences. The patients were followed up from 3 to 8 years with an average of（4.13±1.06） years. All of them got significant improvement of hip function and pain relief. The Harris score significantly improved from（41.65±17.58） before THA to（89.54±3.75） at the latest follow up（P〈0.05）. The X-ray examinations showed that no osteolysis around the prosthesis and prosthetic loosening happened in anyone of them during follow-up. [Conclusion] Total hip arthroplasty is an effective treatment for traumatic arthritis and femoral head necrosis secondary to acetabular fracture.

关 键 词：全髋关节置换术 髋臼骨折 创伤性关节炎 股骨头坏死 

分 类 号：R687.4[医药卫生—骨科学]