摘要
目的:探讨全髋关节置换术后下肢不等长的原因及预防的方法。方法:2001年1月￣2003年12月30例全髋置换术的病人,男17例,女13例,通过术前拍摄高质量的骨盆X线片健侧下肢内旋15°,X线球管距离1m,用模板测量髋臼的旋转中心和偏心距,标志出需切除骨距位置。术中采用比较双侧膝关节是否等长来调节股骨颈的截骨距离和选取人工股骨头的颈长(双膝应平衡),来避免下肢的不等长。结果:1995年6月～2000年7月43例肢体不等长的原因有髋臼位置不良、股骨头的旋转中心的外移、股骨距过长或过短、髋关节屈曲内收挛缩。2001年1月￣2003年12月经术前模板测量术中的肢体测量后,肢体延长的只有5例,并且均在0.5￣0.7cm,不超过1cm。使下肢不等长的发生率大大降低。结论:通过术前的测量和术中对比双膝的长度,来决定股骨距的截骨平面和选取假体的颈长,从而使全髋关节置换术后下肢不等长的发生率明显降低。
Objective：To investigate the reasons and prophylaxis for leg-length inequality in patients undergoing primary total hip arthroplasty. Methods： 30 （male 17, female 13） patients were treated with total hip arthroplasty from Jan. 2000 to Dec. 2002. Before operation, the high-qualitied X-ray pictures of pelvis were got in a manner of that the uninjured side legs rotated internally in 15° and the X-ray tube part of lm from the body. The rotation centers of the acetabulum and the offsets of the femur were measured on templates, after that, the presumptive cutting lines were marked. Using the length of both knees as a landmark, we corrected the cutting lines on the neck of femur, adjusted the femoral prosthesis with different neck length in operation. Results： From Jun. 1996 to Jul. 2000, there were 43 patients with leg-length inequality after total hip arthroplasty, resulted from displace of the acetabulum, lateral aversion of rotation center of the femoral head, length deviation of the calcar fernorale or flexion and adduction of the hip joint. Corrected with managements above-mentioned, there only were 5 patients with excess limb length from 0.5cm to 0.7cm,less than lcrn. The rate of leg-length inequality was cut down significantly.Conclusions： This management of measuring and comparing the length of both knees before and after operation is useful in correction of discrepancy of limbs in total hip arthroplasty.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2006年第2期221-223,共3页
Chinese Journal of Clinical Anatomy
