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[1]潘浩,胡慶豐,朱杭,等.非股骨短縮截骨全髖關(guān)節(jié)置換術(shù)治療 CrowⅣ型髖關(guān)節(jié)發(fā)育不良[J].中醫(yī)正骨,2014,26(10):58-60.
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非股骨短縮截骨全髖關(guān)節(jié)置換術(shù)治療 CrowⅣ型髖關(guān)節(jié)發(fā)育不良()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年10期
頁碼:
58-60
欄目:
臨床報(bào)道
出版日期:
2014-10-30

文章信息/Info

作者:
潘浩1胡慶豐1朱杭1何永江1王堅(jiān)1肖魯偉2賈 高永2朱振安3
1.浙江省杭州市中醫(yī)院,浙江 杭州 310007;
2.浙江中醫(yī)藥大學(xué),浙江 杭州 310053;
3.上海交通大學(xué)附屬第九人民醫(yī)院,上海 200011
關(guān)鍵詞:
關(guān)節(jié)成形術(shù)置換髖 髖脫位先天性 截骨術(shù)
摘要:
目的:觀察非股骨短縮截骨全髖關(guān)節(jié)置換術(shù)治療CrowⅣ型髖關(guān)節(jié)發(fā)育不良的臨床療效與安全性。方法:2002年1月至2008年 2月,采用非股骨短縮截骨全髖關(guān)節(jié)置換術(shù)治療CrowⅣ型髖關(guān)節(jié)發(fā)育不良患者20例21髖,均為女性。年齡36~58歲,中位數(shù)42歲。 單側(cè)19例19髖,雙側(cè)1例2髖。Trendelenburg征均為陽性。術(shù)前均行雙側(cè)髖關(guān)節(jié)正側(cè)位X線及CT檢查,確診為CrowⅣ型髖關(guān)節(jié)發(fā)育 不良。所有患者均表現(xiàn)為髖關(guān)節(jié)疼痛、行走困難,均經(jīng)非手術(shù)治療無效。術(shù)前Harris評分25~60分,中位數(shù)45分。術(shù)后隨訪觀察 并發(fā)癥發(fā)生、肢體短縮糾正及髖關(guān)節(jié)功能恢復(fù)情況。結(jié)果:所有患者均獲得隨訪,隨訪時(shí)間1~6年,中位數(shù)4年。3例3髖術(shù)中發(fā)生 骨折,其中2例2髖股骨小轉(zhuǎn)子輕微骨折,行鋼絲環(huán)扎固定后股骨假體穩(wěn)定,骨折愈合良好; 1例1髖股骨大轉(zhuǎn)子不全骨折,行鋼絲“8 ”字固定后股骨假體穩(wěn)定,骨折愈合良好。l例出現(xiàn)坐骨神經(jīng)刺激癥狀,1例出現(xiàn)股神經(jīng)刺激癥狀,均于術(shù)后1個(gè)月自行恢復(fù)正常。 均無感染、髖關(guān)節(jié)再脫位、假體松動(dòng)及深靜脈血栓形成等并發(fā)癥發(fā)生。肢體短縮均得到滿意糾正,基本達(dá)到肢體等長或短縮小于 2 cm。患者無跛行或僅有輕度跛行。術(shù)后Harris評分79~96分,中位數(shù)85分。髖臼杯外展36°~60°,中位數(shù)41°。重建的髖關(guān) 節(jié)旋轉(zhuǎn)中心向內(nèi)移位 0~5 mm,中位數(shù)3 mm; 向上移位0~5 mm,中位數(shù)2 mm。結(jié)論:采用非股骨短縮截骨全髖關(guān)節(jié)置換術(shù)治療 CrowⅣ型成人髖關(guān)節(jié)發(fā)育不良,能基本恢復(fù)肢體長度,糾正肢體短縮,有利于患肢功能的恢復(fù),并發(fā)癥少,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省杭州市醫(yī)學(xué)重點(diǎn)項(xiàng)目(2010Z0009)
更新日期/Last Update: 2014-10-30