摘要
目的探讨侧前方入路微创小切口髋关节置换术治疗老年股骨颈骨折的可行性。方法2003年2月至2007年3月,采用前外侧小切口对59例59髋行髋关节置换术,其中48为新鲜骨折,11例为陈旧骨折。49例患者行全髋关节置换术,10例患者行单纯股骨头置换术。患者取平卧位,患侧半边臀部略悬空于手术床边,使臀大肌及臀部软组织自然下垂,患侧下肢内收10°,使大粗隆突出部份充分暴露;股骨颈及大粗隆暴露后,先截骨清除股骨颈残端,再前脱位取出股骨头;术毕伤口不放引流,弹力绷带臀部以下均匀包扎。结果手术切口长度7～9cm,平均8cm;手术时间50～70min,平均62min;出血量150～420ml,平均300ml;无严重并发症,3～11d部分负重行走。全部患者获得6～49个月的随访。Harris评分优52例,良6例,中1例,优良率达98%。结论侧前方微创小切口全髋关节置换术治疗老年股骨颈骨折可行,具有创伤小、出血少、安全、并发症少、恢复快等优点。
Objective To evaluate the feasibility of the minimally invasive total hip arthroplasty for aged people with femoral neck fracture through a small anterolateral approach and therapeutic result. Methods From February of 2003 to March of 2007, 59 cases with femoral neck fracture were performed with minimally invasive total hip arthroplasty through a small anterolateral incision. Results The length of skin incision ranged from 7 - 9 cm （ mean 8 cm）. The operation time was 50 ~ 70 minutes （ mean 62 minutes）. The patients had a blood loss of 150 -420 ml （mean 300 ml）. There was no severe complication occurred on this patients group. The follow up of 6 to 49 months, Harris score revealed that all patients in this group had a satisfied clinical result. Conclusion Minimally invasive total hip arthroplasty through a anterolateral skin incision has the advantages of less tissue damage, less blood loss and quick postoperative recovery. It could be used for the hip arthroplasty of aged people who suffered from femoral neck fracture.
出处
《中华关节外科杂志（电子版）》
CAS
2008年第1期19-21,共3页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
髋关节
关节成形术
置换
外科手术
微创性
Hip joint
Arthroplasty, replacement
Surgical procedures, minimally invasive
