解剖型股骨柄假体植入并发股骨近端骨折与股骨近段髓腔解剖分析.DOCVIP

解剖型股骨柄假体植入并发股骨近端骨折与股骨近段髓腔解剖分析 王 敏，张 峡，郝 勇，周 跃，张正丰，李长青 （400037重庆，第三军医大学新桥医院骨科） [摘要] 目的 分析Ribbed解剖型股骨柄假体植入并发股骨近端骨折的原因，探讨股骨髓腔解剖因素在股骨近段骨折中的重要影响。方法 2004年1月至2009年1月，我们采用德国Link公司解剖型股骨柄假体Ribbed柄对213例（254髋）行全髋关节置换术。对213例患者的髓腔形态归纳分析，随访时间最短的1年，最长的5年，平均3.6年，髋关节功能采用Harris评分。 结果 82.63%（176/213）患者的髓腔形态为正常型，香槟型占9.39%（20/213），只有7.98%（17/213）的患者髓腔为烟囱型。术中有11例发生股骨近段的骨折（包括股骨颈骨折5例，大转子骨折6例），占了手术并发症的26.19%（11/42），占本组病例的5.16%（11/213）。骨折主要发生在香槟型患者中，占63.64%（7/11）Abstract] Objective Analysis the reasons of proximal femoral fracture when implanting the anatomy stem, and discussion the important of geometry basis knowledge of proximal femoral canal in order to get optimal selection for stem prosthesis. Methods Between Jan. 2004 and Jan. 2009, 213 patients with 254 hips have been performed total hip replacement because of diversity reasons, the Ribbed stems of Germany Link company were administrated in the research, we analysis the patients’s proximal medullary cavity of the femur, all the people were followed up from 1 to 5 years, for an average of 3.6 years, the function of hips were evaluated by standard of Harris. Results 82.63% patients have normal proximal medullary cavity of the femur, 9.39% patients are type Champagne-flute and only 7.98% show the type Stovepipe. 11 cases suffered from the proximal femoral fracture, it was account for 5.16% in all patients and 26.2% in all complications. 63.6% fracture patients’s proximal femoral canals were belong to the type Champagne-flute. The Harris score were improved remarkably from 40.8 to 93.0 after surgery. Conclusion The complication of fracture of proximal femoral and implanting hardness were due to proximal medullary canal geometry of the femur, which is the key factor for your optimal selection of femoral component. [Key words] anatomy stem; geometry of proximal femoral canal; fracture of proximal femoral Corresponding author: Wang Min, E-mail: wangmin@tmmu.edu.cn [通信作者]: 王 敏，E-mail：wangmin@tmmu.edu.cn 人工髋关节置换术前选择假体时，要考虑在几何学上达