人工股骨头置换术手术策略对下肢长度及髋关节功能的影响  

Effect of different surgical strategies on lower limb length and hip joint function in artificial femoral head replacement

作　　者：王跃 刘畅 何永兵 张鹏礼 WANG Yue;LIU Chang;HE Yongbing;ZHANG Pengli(Department of Orthopedics,Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force,Hefei 230000,China)

机构地区：[1]武警安徽总队医院骨科,合肥230000

出　　处：《武警医学》2024年第11期981-984,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 探讨人工股骨头置换术不同下肢长度均衡策略对术后双下肢长度、髋关节功能的影响。方法 回顾性分析2020-01至2022-12在武警安徽总队医院行人工股骨头置换术78例患者临床资料,按收治时间顺序分为A组(Shuck试验法)、B组(改良头颈比法)、C组(克氏针标记定位法),每组26例,对比3组患者治疗前后双下肢不等长(LLD)值、髋关节Harris评分,并对比3组手术一般情况、术后步态及并发症。结果 B、C组治疗后的LLD值、髋关节Harris评分和术后步速、单腿支撑时间、步频,改善均优于A组(P<0.05),B、C组差异无统计学意义;3组术中出血量、手术时间、住院时间、术后VAS评分和住院费用,均无统计学差异(P>0.05);B组术后并发症发生率最低,优于A、C组(P<0.05),A、C组无统计学差异(P>0.05)。结论 改良头颈比法与克氏针标记定位法均可有效减小人工股骨头置换术后LLD值,有利于术后步态恢复和髋关节功能,优于传统Shuck试验法,其中改良头颈比法为无创方法,简单易行,术后并发症少,更适合老年患者。Objective To investigate the effects of different lower limb length balancing strategies on the postoperative lower limb length and hip joint function after artificial femoral head replacement.Methods A retrospective analysis was conducted on 78 patients who underwent artificial femoral head replacement in Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force between January 2020 and December 2022.According to the order of admission time,26 patients were grouped together,namely Group A(Shuck test method),Group B(improved head neck ratio method),and Group C(Kirschner wneedle marking positioning method).The The unequal length of lower limbs(LLD)value and Harris score of hip joint were compared before and after treatment in 3 groups,and the general surgical condition,postoperative gait and complications were compared in 3 groups.Results After treatment,the LLD value and Harris score of the hip joint and the postoperative gait speed,single leg support time,and stride frequency in groups B and C were better than those in group A(P<0.05),while there was no statistically significant difference between groups B and C(P>0.05).There were no statistically significant differences between the three groups in terms of intraoperative bleeding volume,surgical time,hospital stay,postoperative VAS score,and hospital expenses.The incidence of postoperative complications in Group B was the lowest,which was better than that in Groups A and C(P<0.05),and there was no statistically significant difference between Groups A and C(P>0.05).Conclusions Both the improved head to neck ratio method and the Kirschner needle marking positioning method can effectively reduce the LLD value after artificial femoral head replacement,which is beneficial to the recovery of postoperative gait and hip joint function,and is superior to the traditional Shuck test method.The modified head to neck ratio method is a non-invasive method,simple and easy to implement,with fewer postoperative complications,and is more suitable for elderly patie

关 键 词：下肢长度 人工股骨头置换 Shuck试验 头颈比 克氏针 

分 类 号：R681.8[医药卫生—骨科学]