摘要
目的 :探讨全髋关节置换术中如何准确达到下肢等长。方法 :1996年 5月～ 2 0 0 1年 7月有 88例 ( 92侧 )髋关节置换术 ,男 5 2例 ,女 3 6例。年龄 40～ 96岁 ,平均 62 .5岁。其中有 76例下肢术前不等长。下肢长短状态分为可变下肢长度与不可变下肢长度 ,所有患者术前均进行X线片模板测试及下肢长度测量。不可变下肢长度 (即患肢长短固定 ,不发生变化 )术中采用克氏针标记骨盆、股骨之间距离 ,置入假体后根据实际情况调整长度 ;可变下肢长度 (即术前患肢长短随时可发生变化 )靠“三要素”来衡量。结果 :术前患肢缩短 1～ 4cm的 76例患者中 ,术后仅有 6例患肢延长 0 .5～2cm ,2例患肢缩短 1cm和 2cm ;术前 12例下肢等长患者中有 2例患肢延长 1.5cm和 2cm。结论 :术前模板测试及下肢长短准确测量 ,术中通过克氏针标记骨盆与股骨技术及“三要素”衡量 ,能准确达到下肢等长 ,可以预防下肢不等长。
Objective:To treat limb-length equalization during total hip arthroplasty.Methods:Ninty-two hips(88 patients)undergone primary total hip replacement between May 1996 and July 2001 were included in this study.There were 52 males and 36 females.The age of the patients ranged from 40 to 96 years(mean,62.5years).All patients were classified to changable length and certain length.Evaluation of the limb length discrepancy through clinical measurements and radiographic templates was done preperatively to anticipate the optimal implantation position of the components.For the certain length,between the pelvis and femur were pointed by Steimmann's pin,the length were re-adjusted after insertion of the prosthesis;For the changable length,it was adjusted according to'three cardinal'measurements methods.Results:Six patients had been lengthened 0.5cm to 2cm after surgery in 76 patients with shortened limb ranged 1cm to 4cm preoperatively.Two of 76 patients had been shorted 1cm to 2cm after surgery.Two of 12 patients with equal limb length preoperatively had been lengthened 1.5cm and 2cm.Conclusion:The preoperative measurements,radiographic templating,intraoperative pin technique and three special measurements are helpful in minimizing limb length discrepancy during total hip replacements.The methods of correcting and preventing limb length discrepancy is effective.
出处
《中国矫形外科杂志》
CAS
CSCD
2003年第6期373-376,共4页
Orthopedic Journal of China
