摘要
目的通过临床病例的对比分析研究,探讨髋关节发育不良的患者行全髋置换时,髋臼内壁内移截骨术和传统术式在恢复髋关节旋转中心方面的作用。方法将笔者行传统全髋置换术治疗的髋关节发育不良11例(传统术式组),与文献报道张洪行髋臼内壁内移截骨全髋置换17例(髋臼内壁内移截骨组)进行对比,通过在骨盆正位X线片上绘制Ranawat三角获得髋关节理想旋转中心,测量手术前、后实际股骨头旋转中心距理想旋转中心的水平和垂直距离,探讨两种术式在全髋置换髋臼重建时恢复髋关节旋转中心方面的作用。结果传统术式组术前水平距离为8～58mm,平均25.92mm,术后为6～34mm,平均16.46mm,手术前后比较有统计学差异(t=3.802,P<0.01);术前垂直距离为4～38mm,平均20mm,术后为2～36mm,平均18.46mm,手术前后比较有统计学差异(t=2.589,P<0.05)。两组手术前后水平距离差值的平均值分别为17.36mm、8.81mm,髋臼内壁内移截骨组大于传统术式组,有统计学差异(t=2.56,P<0.05);两组手术前后垂直距离差值的平均值分别为10.41mm、3.47mm,髋臼内壁内移截骨组大于传统术式组,有统计学差异(t=2.27,P<0.05)。结论传统术式有恢复髋关节旋转中心的作用;在恢复髋关节旋转中心作用上,髋臼内壁内移截骨术优于传统术式。
Objective To investigate the different effects of recovering hip joint rotating center in the osteotomy of acetabular medial and the traditional operation when the dysplasia of hip needs total hip replacement （THR）. Methods One group was traditional THR cases in our hospital （11 patients, 11 hips）, and another group was the osteotomy of acetabular medial wall cases （17 patients, 18 hips） reported by Zhanghong. Two groups of cases were contrasted. A ranawat triangle was drawn on the X-ray fLlm, and a supposed optimal rotating center was located. Both of the horizontal and vertical distances between femoral head and supposed rotating center were measured.Results The traditional THR group：the horizontal distance was 25.92 mm （8-58 mm） preoperatively and 16.46 mm （6-34 mm） postoperatively, （t=3.802, P〈0.01）.The vertical distance was 20 mm （4-38 mm） preoperatively and 18.46 mm （2-36 mm） postoperatively, （t=2.598,P〈0.05）.Two group were contrasted. The preoperative horizontal distance minused postoperative horizontal distance got 2 figures which were 17.36mm of the osteotomy of acetabular medial wall group and 8.81 mm of the traditional THR group, （t=2.56,P〈0.05）.As for vertical distance, 2 figures were got which were10.36mm of the osteotomy of acetabular medial wall group and 3.47mm of the traditional THR group, （t=2.27 ,P〈0.05）. Conclusion The traditional THR may recover hip joint rotating center.For the effect of recovering hip joint rotating center, the osteotomy of acetabular medial wall surpasses the traditional THR.
出处
《中国骨与关节损伤杂志》
2010年第1期16-18,共3页
Chinese Journal of Bone and Joint Injury
关键词
髋
发育不良
截骨
旋转中心
Hip
Dysplasia
Osteotomy
Rotating center
