CAJ | 학술논문

目的探讨人工全髋关节置换术(THA)治疗髋关节周围骨折术后关节骨性强直的疗效和可行性.方法选择2008年1月-2013年10月收治的采用生物固定型THA治疗的髋关节周围骨折术后关节骨性强直患者23例,其中男16例,女7例;年龄23 ～ 67岁,平均43岁.内固定手术与THA间隔12 ～ 73个月,平均38个月.结果所有患者均获得随访3～ 60个月,平均28个月.23例所有假体均取得良好的生物压配,髋臼外翻角平均43.3°、前倾角平均22.5°,股骨假体前倾角平均16.4°.术后切口均Ⅰ期愈合,未见感染或假体松动、脱位、假体周围骨折等并发症.1例术后2个月出现患肢肿胀,经超声多普勒检查示股静脉不全栓塞,经卧床、抬高患肢及抗凝等治疗3个月后肿胀消退.术后19例双下肢基本等长(短缩＜0.5 cm),3例患肢短缩(0.8 ～1.4 cm),1例患肢延长0.8 cm.术后髋关节功能Harris评分由术前(42.16 ±3.03)分提高至末次随访时的(93.08 ±5.23)分(P＜0.05).结论 THA治疗髋关节周围骨折术后关节骨性强直,利用髋关节功能恢复,明显提高患者生活质量.
목적 탐토인공전관관절치환술(THA)치료관관절주위골절술후관절골성강직적료효화가행성.방법 선택2008년1월-2013년10월수치적채용생물고정형THA치료적관관절주위골절술후관절골성강직환자23례,기중남16례,녀7례;년령23 ～ 67세,평균43세.내고정수술여THA간격12 ～ 73개월,평균38개월.결과 소유환자균획득수방3～ 60개월,평균28개월.23례소유가체균취득량호적생물압배,관구외번각평균43.3°、전경각평균22.5°,고골가체전경각평균16.4°.술후절구균Ⅰ기유합,미견감염혹가체송동、탈위、가체주위골절등병발증.1례술후2개월출현환지종창,경초성다보륵검사시고정맥불전전새,경와상、태고환지급항응등치료3개월후종창소퇴.술후19례쌍하지기본등장(단축＜0.5 cm),3례환지단축(0.8 ～1.4 cm),1례환지연장0.8 cm.술후관관절공능Harris평분유술전(42.16 ±3.03)분제고지말차수방시적(93.08 ±5.23)분(P＜0.05).결론 THA치료관관절주위골절술후관절골성강직,이용관관절공능회복,명현제고환자생활질량.
Objective To discussion the feasibility and effect of total hip arthroplasty (THA) of postoperative ankylosis in patients with hip peripheral fracture.Methods From January 2008 to October2013,cementless THA was performed in 23 patients with ankylosis after internal fixation of hip peripheral fracture.There were 16 males and 7 females,aged 23 to 67 years (mean,43 years).Interval between internal fixation and THA was 12 to 73 months (mean,38 months).Results Mean follow-up was 28 months (range,3 to 60 months).All patients presented good press-fit prostheses with mean acetabular valgus of 43.3°,mean acetabular anteversion of 22.5°,and mean femoral anteversion of 16.4°.Primary wound healing was detected with no occurrence of infection,prosthetic loosening or dislocation,and periprosthetic fracture.Femoral vein incomplete embolism was diagnosed in one patient with limb swelling 2 months after operation,but swelling subsided after 3 months of bed rest,elevation of the affected limb and anticoagulant therapy.Length of the bilateral limbs was almost equal in 19 patients with the difference within 0.5 cm,but the affected limb was 0.8-1.4 cm shorter in 3 patients and was 0.8 cm longer in 1 patient.Harris hip score improved from (42.16 ± 3.03)points before operation to (93.08 ± 5.23) points at the last follow-up (P ＜ 0.05).Conclusion THA is associated with good hip function recovery and improved quality of life during the treatment of postoperative ankylosis in patients with hip peripheral fracture.