髂前下棘解剖学形态对股骨颈骨折患者全髋关节置换术影响研究  

The influence of different anatomical patterns of anterior inferior iliac spine on total hip arthroplasty in patients with femoral neck fracture

作　　者：孙豪君 韩文锋 刘斌 王铮 王宁 SUN Hao-jun;HAN Wen-feng;LIU Bin;WANG Zheng;WANG Ning(Department of Orthopedics,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2024年第4期233-236,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨髂前下棘不同的解剖学形态对股骨颈骨折患者全髋关节置换术的影响。方法选取自2018年1月至2021年1月在北部战区总医院骨科收治的123例股骨颈骨折患者的临床资料。所有患者均进行全髋关节置换术,根据手术中安装假体后脱位测试是否发生髂前下棘撞击,分为撞击组(n=46)与非撞击组(n=77)。所有患者的随访时间≥12个月,比较两组患者术中下肢屈曲90°内旋时的脱位角度,旋转中心上移距离,术后末次随访时的Harris评分等。结果撞击组与非撞击组患者在术中屈曲90°并内旋时发生脱位的内旋脱位角度分别为(25.26°±5.89°)、(57.32°±9.91°),两组间比较,差异有统计学意义(P<0.05);撞击组患者在进行髂前下棘成形术后的内旋脱位角度为(55.63°±4.90°),与成型前比较,差异有统计学意义(P<0.05)。髂前下棘成形术后,撞击组与非撞击组患者的脱位角度比较,差异无统计学意义(P>0.05)。撞击组与非撞击组患者THA术后旋转中心上移距离比较,差异无统计学意义(P>0.05)。末次随访时,撞击组与非撞击组患者在疼痛、功能方面的术后Harris评分比较,差异无统计学意义(P>0.05)。结论股骨颈骨折患者行全髋关节置换屈曲内旋时,可能造成股骨与髂前下棘的撞击,术中进行髂前下棘及股骨前缘的成型,可以有效改善术后关节活动度,降低脱位率。Objective To explore the influence of different anatomical patterns of anterior inferior iliac spine on total hip arthroplasty in patients with femoral neck fracture.Methods A total of 123 patients with femoral neck fracture admitted to the Department of Orthopaedics of the General Hospital of the Northern Theatre from January 2018 to January 2021 were retrospectively analysed as study subjects.All patients underwent total hip arthroplasty and were divided into an impingement group(n=46)and a non-impingement group(n=77)based on whether or not impingement of the anterior inferior iliac spine occurred when the dislocation test was performed after the prosthesis was installed during the surgery.Patients were followed up for more than 12 months,and the two groups were compared in terms of the angle of subluxation during intraoperative flexion of the lower limb at 90°of internal rotation,the distance of upward movement of the centre of rotation,and the Harris score at the final postoperative follow-up.Results The internal rotation dislocation angles of patients in the impingement group and non-impingement group were(25.26°±5.89°)and(57.32°±9.91°),respectively,with statistical significance(P<0.05).The internal rotation dislocation Angle of patients in the impingement group was(55.63°±4.90°)after the anterior inferior iliac spinoplasty,compared with that before the surgery,the difference was statistically significant(P<0.05).After anterior inferior iliac spinoplasty,there was no significant difference in dislocation angle between the impingement group and the non-impingement group(P>0.05).There was no significant difference in the distance of upward rotation center between the impingement group and the non-impingement group(P>0.05).At the last follow-up,there was no significant difference in postoperative Harris scores in pain and function between the impingement group and the non-impingement group(P>0.05).Conclusion Total hip replacement in patients with femoral neck fracture may cause impingement of the femu

关 键 词：股骨颈骨折 髂前下棘 全髋关节置换术 

分 类 号：R687.3[医药卫生—骨科学]