中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
9期
690-692
,共3页
张道俭%朱天岳%柴卫兵%卢宏章%李军%刘震宁%叶一林
張道儉%硃天嶽%柴衛兵%盧宏章%李軍%劉震寧%葉一林
장도검%주천악%시위병%로굉장%리군%류진저%협일림
关节成形术,置换,髋%髋假体%骨折
關節成形術,置換,髖%髖假體%骨摺
관절성형술,치환,관%관가체%골절
Arthroplasty,replacement,hip%Hip prosthesis%Fracture
目的 分析全髋关节置换术中解剖柄引起股骨假体周围骨折的影像学测量的意义.方法 回顾性分析2001年1月至2011年1月北京大学第一医院骨科144例使用解剖柄初次全髋关节置换中7例术中发生股骨假体周围骨折的骨折组病例及21例未发生骨折的非骨折组病例,测量术前髋关节X线片的髋臼Sharp's角、CE角、股骨颈干角、前倾角、股骨干近段的前弓角度、股骨近段最窄髓腔直径,查阅病历,记录患者身高、体重,并了解手术细节.对测量结果用SPSS 17.0进行独立样本t检验统计学分析.结果 骨折组与非骨折组一般情况及髋臼Sharp's角、CE角差异无统计学意义,测量比较股骨颈前倾角(25.7±8.7)°比(14.9±3.2)°,(P =0.040)、颈干角(138.9±7.1)°比(134.4±4.0)°,(P=0.026)、股骨干前弓角(173.6±3.5)°比(171.2±1.4)°,(P=0.024)、峡部髓腔直径(11.5±1.9)°比(12.2±1.0)°,(P =0.021),差异有统计学意义.结论 股骨近段发育异常是导致全髋关节置换术中使用解剖柄股骨假体周围骨折的主要原因.
目的 分析全髖關節置換術中解剖柄引起股骨假體週圍骨摺的影像學測量的意義.方法 迴顧性分析2001年1月至2011年1月北京大學第一醫院骨科144例使用解剖柄初次全髖關節置換中7例術中髮生股骨假體週圍骨摺的骨摺組病例及21例未髮生骨摺的非骨摺組病例,測量術前髖關節X線片的髖臼Sharp's角、CE角、股骨頸榦角、前傾角、股骨榦近段的前弓角度、股骨近段最窄髓腔直徑,查閱病歷,記錄患者身高、體重,併瞭解手術細節.對測量結果用SPSS 17.0進行獨立樣本t檢驗統計學分析.結果 骨摺組與非骨摺組一般情況及髖臼Sharp's角、CE角差異無統計學意義,測量比較股骨頸前傾角(25.7±8.7)°比(14.9±3.2)°,(P =0.040)、頸榦角(138.9±7.1)°比(134.4±4.0)°,(P=0.026)、股骨榦前弓角(173.6±3.5)°比(171.2±1.4)°,(P=0.024)、峽部髓腔直徑(11.5±1.9)°比(12.2±1.0)°,(P =0.021),差異有統計學意義.結論 股骨近段髮育異常是導緻全髖關節置換術中使用解剖柄股骨假體週圍骨摺的主要原因.
목적 분석전관관절치환술중해부병인기고골가체주위골절적영상학측량적의의.방법 회고성분석2001년1월지2011년1월북경대학제일의원골과144례사용해부병초차전관관절치환중7례술중발생고골가체주위골절적골절조병례급21례미발생골절적비골절조병례,측량술전관관절X선편적관구Sharp's각、CE각、고골경간각、전경각、고골간근단적전궁각도、고골근단최착수강직경,사열병력,기록환자신고、체중,병료해수술세절.대측량결과용SPSS 17.0진행독립양본t검험통계학분석.결과 골절조여비골절조일반정황급관구Sharp's각、CE각차이무통계학의의,측량비교고골경전경각(25.7±8.7)°비(14.9±3.2)°,(P =0.040)、경간각(138.9±7.1)°비(134.4±4.0)°,(P=0.026)、고골간전궁각(173.6±3.5)°비(171.2±1.4)°,(P=0.024)、협부수강직경(11.5±1.9)°비(12.2±1.0)°,(P =0.021),차이유통계학의의.결론 고골근단발육이상시도치전관관절치환술중사용해부병고골가체주위골절적주요원인.
Objective To explore the imaging reasons for periprosthetic femoral fractures during the operation of total hip arthroplasty with anatomic prosthesis.Methods The fracture group consisted of 7 cases with periprosthetic femoral fracture (PPFF) and the non-fracture group 21 cases without PPFF during the operation of total hip arthoplasty (THA) among the 144 cases of primary THA with anatomic prosthesis.The preoperative plain films of hip joint were taken to calibrate the Sharp's angle,centre edge (CE) angle,femoral neck shaft angle,femoral anteversion angle of neck,bowing angle of proximal femoral shaft part,width of narrowest part in proximal femoral shaft.For each case,surgical details,age,height and weight were recorded.The results were analyzed with independent sample t test by software SPSS 17.0.Results No significant difference existed in general situation,Sharp's angle and CE's angle between two groups.And there were significant differences in femoral neck shaft angle (P =0.040),femoral anteversion angle of neck (P =0.026),bowing angle of proximal femoral shaft part (P =0.024),width of narrowest part in proximal femoral shaft (P =0.021).Conclusion Dysplasia of proximal femur is a major cause of periprosthetic femoral fracture during the operation of total hip arthroplasty with anatomic prosthesis.
