股骨颈量化截骨在初次人工髋关节置换术中应用.docVIP

股骨颈量化截骨在初次人工髋关节置换术中的应用 　　[摘要] 目的 探索一种在初次髋关节置换术中控制双下肢不等长的新方法。 方法 对2010年1～5月100例正常成年人的髋关节正位DR片进行相关数据测量，依据等长原理，得出股骨颈截骨公式：L=H+M-h。从2010年6月～2015年12月中山市南朗医院骨科收治的76例股骨颈骨折中选取符合入选标准需施行人工髋关节置换患者45例（45侧），采用随机数字表法将其分为实验组（23例23侧，采用量化截骨）和对照组（22例22侧，采用传统方法截骨）。术后测量术侧（h+L）值和健侧（H+M）值，比较两者间的差异；术后髋关节功能按髋关节Harris评分评定；术后12个月通过问卷调查的形式比较两组双下肢长度差异感。 结果 45例中41例获得12～48个月的随访，实验组术侧和健侧的下肢长度比较差异无统计学意义（P 0.05），对照组术侧和健侧的下肢长度比较差异有统计学意义（P 0.05）；问卷调查显示，实验组20例均无长度差异感，对照组3例有轻微长度差异感；本组病例术后无感染、脱位和假体下沉等并发症发生。 结论 股骨颈量化截骨在初次人工髋关节置换术中能精确控制股骨矩截骨平面，从而确保术后双下肢真正等长。股骨颈截骨公式使截骨得以量化，不因手术者不同而出现较大误差，且影响数据的可变因素少，确保了科学性、可重复性和可行性，是一种准确性高、可重复性强、操作简易的控制髋关节置换术中双下肢不等长的新方法，值得临床推广应用 [关键词] 股骨颈；量化截骨；初次；人工髋关节置换术 [中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210（2016）10（b）-0107-04 [Abstract] Objective To explore a new method of controlling unequal length of both lower extremities in primary artificial hip replacement. Methods The relevant data of anteroposterior direct radiography （DR） of hip joint in 100 normal adults from January to May 2010 was measured. According to the principle of equal length， the formula for osteotomy of neck of femur： L=H+M-h， was obtained. 45 cases （45 sides） of patients scheduled for artificial hip replacement accorded with the inclusion criteria were selected from 76 patents with fracture of neck of femur admitted to Nanlang Hospital of Zhongshan City from June 2010 to December 2015， and they were randomly divided into experimental group （23 cases， 23 sides， treated by quantizing osteotomy） and control group （22 cases， 22 sides， treated by traditional osteotomy）. The values of （h+L） of the surgical sides and those of （H+M） of the healthy sides were measured after surgery， the difference of the two sides was compared. The postoperative function of the hip joint was assessed according to Harris score. The different feelings of the length of both lower extremities after operation between the two groups were compared through questionnaire survey. Results Among 45 cases， 41 cases of patients were followed-