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带线锚钉修复髋关节后外侧复合体防止双极人工股骨头假体脱位
Repairing hip posterolateral complex with suture anchors to prevent postoperative prosthesis dislocation after bipolar hemiarthroplasty
  
DOI:
中文关键词:  髋关节  后外侧复合体  锚钉  假体脱位  修复
英文关键词:Hip posterolateral complex(HPLC)  Suture anchors  Prosthesis dislocation  Repair
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作者单位
石波1 谢明锐1 王东1 石宇洲2  
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中文摘要:
      目的 评价带线锚钉修复髋关节后外侧复合体对防止双极人工股骨头置换术后假体脱位的效果。方法 回顾性分析。2009年6月~2016年6月绵阳市中心医院收治的57例(58髋)股骨颈骨折患者纳入本研究。男23例,女34例;年龄75.5~97岁,平均83.6岁;骨折Garden分型:Ⅱ型12髋,Ⅲ型27髋,Ⅳ型19髋。采用髋关节后方切口,切开并保留韧带、关节囊形成髋关节后外侧复合体结构(Hip posterolateral complex, HPLC),在大转子后缘植入带线锚钉,人工双极股骨头置换术毕用带线锚钉修复HPLC。结果 术中髋关节屈曲100°运动实验,缝合HPLC前假体脱位率74.14%(43/58),缝合HPLC后未见假体脱位,差别有统计学意义(P>0.05)。术后随访3~36月(平均18.1月),随访期间,无人工关节脱位。末次随访时髋关节Harris评分平均为91.57分,其中优44髋、良9髋、可5髋,优良率为91.37%。患髋关节活动度同健侧相比没有统计学差异(P>0.05)。结论 带线锚钉修复HPLC可防止双极人工股骨头术后脱位。
英文摘要:
      Objective To evaluate the effect of repairing hip posterolateral complex(HPLC)with suture anchors to prevent postoperative prosthesis dislocation after bipolar hemiarthroplasty. Methods A retrospective study was designed. From June 2009 to June 2016, 57 senile patients(58 hips)with femoral neck fracture were treated operatively in Mianyang central hospital (Sichuan, China). There were 23 males and 34 females. 75.5 to 97 years of old(mean, 83.6 years). There were 12 hips of Garden type II, 27 hips of Garden type III and 19 hips of Garden type IV. The HPLC was repaired with suture anchors after the bipolar prostheses were implanted. Results The 57 patients (58 hips)were evaluated during the hospitalization period and a mean follow up period of 18.3 months(from 6 to 36 months). Intraoperative hip flexion examination of 100°, the prosthesis dislocation rate was 74.14%(43/58)before repairing HPLC, there was none of prosthesis dislocation after repairing HPLC. No dislocation happened in this group. At the last follow-up, 46 patients had no pain, 10 had mild pain, and 2 had moderate pain. The mean Harris Hip Score was 91.57, functional outcome was excellent in 44 hips, good in 9, fair in 5, giving an excellent to good rate of 91.37%. Conclusion Repairing HPLC with suture anchors was effective to prevent postoperative prosthesis dislocation.
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