全髋关节置换术后双下肢不等长的评估与处理策略  

Evaluation and treatment strategy of limb length discrepancy after total hip arthroplasty

作　　者：李超[1] 季明亮 张万双 陆军[1] 李永刚[1] Li Chao;Ji Mingliang;Zhang Wanshuang;Lu Jun;Li Yonggang(Department of Orthopaedic Surgery,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Spine Surgery,Hefei Orthopaedic Hospital,Hefei 238000,China)

机构地区：[1]东南大学附属中大医院骨科,南京210009 [2]合肥市骨科医院脊柱外科,合肥238000

出　　处：《中华外科杂志》2023年第2期95-99,共5页Chinese Journal of Surgery

基　　金：国家自然科学基金 (81972105)。

摘　　要：双下肢不等长(LLD)是全髋关节置换术(THA)后的常见并发症。在保证髋关节稳定性,即良好的假体位置和软组织张力的前提下,术后双下肢等长能提高患者的满意度。术前对患者进行综合评估有利于预防术后LLD的发生,因此,术前应详细分析骨盆-脊柱状况和LLD的类型及原因。术中结合触摸髌骨位置、克氏针定位及参考股骨头中心和大转子尖的位置关系等方法来调整肢体长度。术后需明确区分真性LLD和功能性LLD,根据患者的症状和双下肢长度差异,制定合理的治疗方案。本文通过回顾最新文献,结合临床实践经验,总结了THA术后LLD的研究现状,以期对关节外科医师对该手术后并发症的深入了解有所帮助。Limb length discrepancy(LLD)is a common complication after total hip arthroplasty(THA).Good positioning of the prosthesis and suitable soft tissue tension are essential to ensure hip joint stability.Patients will be more satisfied if almost the same length of both lower extremities is achieved.Preoperative comprehensive evaluation of patients is helpful to prevent the occurrence of LLD after surgery.Therefore,the pelvic spine conditions,as well as type and cause of LLD should be analyzed in detail before surgery.During operation,limb length should be adjusted by touching the position of patella,Kirschner′s wires positioning and referring to the relationship between the center of femoral head and the tip of greater trochanter.After surgery,it is necessary to clearly distinguish true LLD from functional LLD,and make a reasonable therapeutic plan according to patient′s symptoms and the range of differences in limb length.This article reviews the latest literatures based on clinical practice experience and summarizes the research status of LLD after THA,which helps joint surgeons to have an in-depth understanding of this postoperative complication.

关 键 词：关节成形术 置换 髋 手术后并发症 双下肢不等长 

分 类 号：R687.4[医药卫生—骨科学]