中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (4): 456-458.doi: 10.13418/j.issn.1001-165x.2017.04.021

• 临床研究 • 上一篇    下一篇

平卧位下改良前外侧入路人工全髋关节置换术的初步探讨

肖智青,  徐洲发,  朱锦忠,  王凤龙,  王爱明,  陈焕文,  林子华,  黄世海,  邓志生,  刘勇   

  1. 广东省河源市中医院骨伤科,广东 河源 517000
  • 收稿日期:2017-03-05 发布日期:2017-08-30
  • 作者简介:肖智青(1971-),男,广东河源人,硕士,主任医师,主要从事关节外科、运动医学、脊柱外科、创伤骨科等方面的研究。E-mail:xiaozhiqingys@sina.com
  • 基金资助:

    河源市社会发展科技计划项目(河科【2015】80号-36)

The preliminary study of modified anterolateral approach for total hip arthroplasty in supine position

XIAO Zhi-qing,  XU Zhou-fa,  ZHU Jin-zhong,  WANG Feng-long,  WANG Ai-ming,  CHEN Huan-wen,  LIN Zi-hua, HUANG Shi-hai, DENG Zhi-sheng,  LIU Yong   

  1. Department of Orthopaedics, Heyuan Hospital of Traditional Chinese Medicine, Heyuan, Guangdong 517000, China 
  • Received:2017-03-05 Published:2017-08-30

摘要:

目的 探讨平卧位下改良前外侧入路全髋关节置换术的技术要点以及疗效。  方法 2013 年8月- 2016 年8 月采用平卧位下改良前外侧入路全髋关节置换术321例,男170例,女151例,年龄在46~84岁,平均76岁,记录切口长度、术中出血量、手术时间、术后下地时间、术后3月跛行率及Trendelenburg 征阳性率、并发症,随访髋关节Harris 评分。  结果 切口长度平均为8.4cm(7.0~10.0)cm,术中出血量平均165ml(110~300)ml,手术时间平均40 min(30~50)min,术后平均下地行走时间为2.5d(2~5 d),术后3个月跛行率及Trendelenburg 征阳性率3%,未出现脱位、假体位置不良情况,随访时间最短3月,最长达3年,平均Harris 评分达94.5 分。   结论 平卧位下改良前外侧入路全髋关节置换术疗效确切,创伤小、恢复快、值得临床推广。

关键词: 髋关节,  ,  , 关节置换,  ,  , 平卧位,  ,  , 改良手术入路

Abstract:

 Objective  To analyze the effect and the key technical points of modified anterolateral approach for total hip arthroplasty in supine position.  Methods  During August 2013 to August 2016, 321 cases(170 males and 151 females) underwent the modified anterolateral approach for total hip  arthroplasty in supine position. The length of incision, intraoperative blood loss, operation time, postoperative ambulation time, claudication rate and trendelenburg positive rate 3 months postoperatively, and complications were recorded and Harris score was adopted for grading the function of the hip joint.  Results   The average length of incision was 8.4 cm (7.0~10.0) cm, the average amount of bleeding was 165 ml (110~300) ml, the average operation time was 40 min (30~50 min) , and the average postoperative ambulation time was 2.5 days (2~5 days). 3 months postoperatively the claudication rate and trendelenburg syndrome with positive rate were 3%, and nobody had dislocation and defective prosthesis position; the follow-up period with a range of 3 months to 3 years revealed that the average Harris score was 94.5 points.   Conclusion  The modified anterolateral approach for total hip arthroplasty in supine position was a good surgical option with merits such as small trauma and quick recovery, suggesting thai is worth for clinical promotion.

Key words: Hip joint;  , Arthroplasty;  , Supine position; , Modified surgical approach