摘要
目的探讨一种减少髋臼杯外展角安放的偏差,提高其在Lewinnek安全范围比率的新方法。方法 2009年1月～2010年4月,共对60例患者(64例髋)采用侧卧位后外侧入路进行全髋关节置换术(THR)。实验组(有调整髂后上棘连线)29例患者(31髋),对照组(未调整髂后上棘连线)31例患者(33髋)。实验组手术时利用激光水平仪调整手术床头尾侧倾斜的角度,通过校正髂后上棘连线,间接使泪滴连线垂直于水平面,从而纠正骨盆的外展或内收。结果实验组术后髋臼杯外展角与目标值偏差>5°的比率为25.8%,对照组为60.6%,两者间差异有统计学意义(P<0.01);实验组术后髋臼杯外展角位于Lewinnek安全范围的比率为90.3%,对照组为63.6%,两者间差异有统计学意义(P<0.05)。结论手术时精确调整髂后上棘连线可纠正骨盆的外展或内收,从而减少髋臼杯外展角安放的偏差,提高其在Lewinnek安全范围的比率。该方法简单,易操作,在临床上具有可靠的实用价值。
Objective To investigate a new method for reducing the deviation of acetabular cup abduction angle and improving its percentage in Lewinnek＇s safe zone.Methods 64 （60 patients） total hip replacements （THR） were operated by posteriolateral approach since January,2009 to April,2010.These patients were divided into two groups.Experimental group included 31 hips （29 patients） from January,2010 to April,2010.Control group included 33 hips （31 patients） from January,2009 to December,2009.The laser instrument was used to correct the posterior interspinal line （ie,the line drawn between the posterosuperior iliac spines [PSIS]） by adjusting the angle of operating table.In this way,the interteardrop line was perpendicular to the horizontal plane in experimental group,so that pelvic abduction or adduction was corrected.Results For the deviation of acetabular cup abduction angle more than five degree,the percentage was 25.8% in the experimental group,and was 60.6% in the control group.There was a significant difference between the two groups （P〈0.01）.The percentage of acetabular cup abduction angle in the Lewinnek＇s safe zone was 90.3% in the experimental group,and was 63.6% in the control group.There was a significant difference between the two groups（P〈0.05）.Conclusions The laser instrument was used to correct the posterior interspinal line by adjusting the angle of operating table,by which the interteardrop line was perpendicular to the horizontal plane,so that pelvic abduction or adduction was corrected.This is a useful method to reduce the deviation of acetabular cup abduction angle and improve its percentage in the Lewinnek＇s safe zone.This method is simple and easy to operate,which is of good value in the clinic.
出处
《中华关节外科杂志（电子版）》
CAS
2010年第5期24-28,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
佛山市科技局科技攻关项目(201008022)
关键词
髂后上棘
关节成形术
置换
髋
髋臼杯
Posterosuperior iliac spine
Arthroplasty, replacement, hip
Acetabular cup
作者简介
通讯作者：张毅E—mail：zyi@fsyyy．com.
