中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
43期
7514-7520
,共7页
关群%冯世龙%唐进%廖乙名%杨涛%程军
關群%馮世龍%唐進%廖乙名%楊濤%程軍
관군%풍세룡%당진%료을명%양도%정군
骨关节植入物%人工假体%髋臼骨折一期%特殊骨折类型%切开复位内固定%髋关节%置换%生物型假体%骨水泥假体
骨關節植入物%人工假體%髖臼骨摺一期%特殊骨摺類型%切開複位內固定%髖關節%置換%生物型假體%骨水泥假體
골관절식입물%인공가체%관구골절일기%특수골절류형%절개복위내고정%관관절%치환%생물형가체%골수니가체
acetabulum%fractures%internal fixators%arthroplasty,replacement%follow-up studies
背景:髋臼骨折最有效的治疗方法是采用切开复位内固定。然而某些特殊类型的髋臼骨折切开复位内固定治疗预后均不理想,容易发生创伤性关节炎和股骨头缺血性坏死等并发症。目的:观察特殊类型髋臼骨折患者行切开复位内固定一期全髋关节置换的效果。方法:髋臼骨折12例,车祸伤7例,压砸伤3例,坠落伤2例。骨折类型:后壁骨折2例,后柱伴后壁骨折2例,T型骨折1例,横行伴后壁骨折5例,臼顶粉碎性骨折2例。伴有股骨头中心性脱位1例,后脱位5例,股骨头骨折3例。患者受伤前患有髋关节骨性关节炎3例,股骨头缺血性坏死2例。采用髋臼骨折切开复位内固定一期全髋关节置换,其中生物型假体9例,骨水泥型假体3例。入院距置换时间3-15 d,平均6 d。置换后第1年每2个月随访患者1次,应用Harris评分评估髋关节功能恢复情况。结果与结论:12例患者置换后无伤口及深部感染,无关节脱位,无下肢深静脉栓塞,无死亡病例。其中11例获得长期随访,时间6-82个月。复位的髋臼骨折在6-16个月愈合,无假体松动及下沉等。末次随访时根据Harris评分法评估髋关节功能恢复情况:优8例,良2例,可1例,优良率为91%。髋臼骨折切开复位内固定一期全髋关节置换可避免长期卧床,尽早下床活动及有效的肢体功能训练,减少并发症,进而重建一个无痛的、功能良好的髋关节。
揹景:髖臼骨摺最有效的治療方法是採用切開複位內固定。然而某些特殊類型的髖臼骨摺切開複位內固定治療預後均不理想,容易髮生創傷性關節炎和股骨頭缺血性壞死等併髮癥。目的:觀察特殊類型髖臼骨摺患者行切開複位內固定一期全髖關節置換的效果。方法:髖臼骨摺12例,車禍傷7例,壓砸傷3例,墜落傷2例。骨摺類型:後壁骨摺2例,後柱伴後壁骨摺2例,T型骨摺1例,橫行伴後壁骨摺5例,臼頂粉碎性骨摺2例。伴有股骨頭中心性脫位1例,後脫位5例,股骨頭骨摺3例。患者受傷前患有髖關節骨性關節炎3例,股骨頭缺血性壞死2例。採用髖臼骨摺切開複位內固定一期全髖關節置換,其中生物型假體9例,骨水泥型假體3例。入院距置換時間3-15 d,平均6 d。置換後第1年每2箇月隨訪患者1次,應用Harris評分評估髖關節功能恢複情況。結果與結論:12例患者置換後無傷口及深部感染,無關節脫位,無下肢深靜脈栓塞,無死亡病例。其中11例穫得長期隨訪,時間6-82箇月。複位的髖臼骨摺在6-16箇月愈閤,無假體鬆動及下沉等。末次隨訪時根據Harris評分法評估髖關節功能恢複情況:優8例,良2例,可1例,優良率為91%。髖臼骨摺切開複位內固定一期全髖關節置換可避免長期臥床,儘早下床活動及有效的肢體功能訓練,減少併髮癥,進而重建一箇無痛的、功能良好的髖關節。
배경:관구골절최유효적치료방법시채용절개복위내고정。연이모사특수류형적관구골절절개복위내고정치료예후균불이상,용역발생창상성관절염화고골두결혈성배사등병발증。목적:관찰특수류형관구골절환자행절개복위내고정일기전관관절치환적효과。방법:관구골절12례,차화상7례,압잡상3례,추락상2례。골절류형:후벽골절2례,후주반후벽골절2례,T형골절1례,횡행반후벽골절5례,구정분쇄성골절2례。반유고골두중심성탈위1례,후탈위5례,고골두골절3례。환자수상전환유관관절골성관절염3례,고골두결혈성배사2례。채용관구골절절개복위내고정일기전관관절치환,기중생물형가체9례,골수니형가체3례。입원거치환시간3-15 d,평균6 d。치환후제1년매2개월수방환자1차,응용Harris평분평고관관절공능회복정황。결과여결론:12례환자치환후무상구급심부감염,무관절탈위,무하지심정맥전새,무사망병례。기중11례획득장기수방,시간6-82개월。복위적관구골절재6-16개월유합,무가체송동급하침등。말차수방시근거Harris평분법평고관관절공능회복정황:우8례,량2례,가1례,우량솔위91%。관구골절절개복위내고정일기전관관절치환가피면장기와상,진조하상활동급유효적지체공능훈련,감소병발증,진이중건일개무통적、공능량호적관관절。
BACKGROUND:The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head. OBJECTIVE:To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture. METHODS:Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of fal ing injury. The type of bone fracture:two cases of posterior wal fracture, two cases of posterior column and posterior wal fracture, one case of T shaped fracture, five cases of transverse and posterior wal fracture, and two cases of acetabular roof sexual fracture. Complications:one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. Al the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were fol owed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery. RESULTS AND CONCLUSION:No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were fol owed-up for a longtime;the fol ow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final fol ow-up according to the Harris score:excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functional y.