胡如印 田晓滨 孙立 韩伟 田家亮 杨先腾 作者单位:550002 贵州 贵阳,贵州省人民医院 关节外科第一作者:胡如印,男,主任医师,主要研究方向:关节外科。 E-mail:huruyin@yahoo.cn摘 要 [目的] 探讨髋关节强直畸形行全髋关节置换术的方法和疗效。[方法] 对我院2005年1月-2011年12月人工全髋关节置换术治疗髋关节强直畸形26例,男性18例,女性7例;年龄31~62岁,平均47.7岁;按导致髋关节强直因素分类:RA 9例(14髋),AS13例(20髋),股骨头坏死并髋臼内陷症2例(2髋),髋关节结核1例,医源性融合1例(1髋); 病程11~39年。就临床疗效及手术相关问题进行分析。[结果] 其中23例获得0.5~5年随访,23例(34髋)Harris评分术前平均38.4分, 术后平均87.6分。术后无感染、神经血管损伤和脱位等近期并发症。术后髋痛消失, 膝痛、下腰痛明显改善, 步态基本恢复正常, 生活基本能自理,8例回到工作岗位。[结论] 对于髋关节骨性强直畸形, 全髋关节置换术能有效消除疼痛, 迅速改善关节功能, 合理掌握手术的适应证、方法和术后功能锻炼是获得理想结果的关键。要减少置换术后并发症的发生,必须考虑到各方面的因素的影响,选择合适的适应证,采用恰当的固定方法,应用新一代负重面及生物固定技术、正确的术前术后处理等,都将对延长假体使用寿命起到有益的作用。
2014年贵州省骨科年会暨贵州省医学会骨科学分会第九届第一次学术会议通知为了加强我省骨科同道的沟通与学术交流,经多方协商决定,2014年贵州省骨科年会暨贵州省医学会骨科学分会第九届第一次学术会议由仁怀市人民医院人民医院承办。会议定于2014年7月11日-13日在风景优美、酒香怡人的仁怀市召开,会议将设立两个分会场,将就关节外科、脊柱外科及创伤骨科等方面进行充分讨论、交流。我们真诚欢迎各位极积投稿,踊跃参加。..........................................................................................会议安排:1、报道时间:2014年7月11日2、会议地址及报到地点:仁怀市天豪大酒店(酒都新区国酒大道)3、会议时间:7月11日-7月13日住宿:仁怀市天豪大酒店(费用自理,按回执统一安排,可将本单位或个人参会情况以电子邮件发到huruyin1975@126.com.如无回执住宿自理。)
Hu Ru-yin, Tian Xiao-bin, Sun Li, Han Wei, Tian Jia-liangAbstractBACKGROUND:Periprostheticfracture are common complications after total hip arthroplasty,and the incidence rate is increased continuously, therefore, the improvement ofmethods and technology for the treatment of fractures around femoral prosthesishas become a research topic.OBJECTIVE: To explore thetherapeutic effect of various internal fixations for treatment of fracturesaround femoral prosthesis after total hip arthroplasty, and to provide atheoretical reference information for the improvement of treatment technologyas well as the improvement of the quality of life in patients.METHODS: The factors andinternal fixation of the fractures around prosthesis during and after total hiparthroplasty were analyzed through experimental data analysis, especially theclinical effects of shape memory alloy embracing fixcator and locking plateinternal fixation for the treatment of fractures around femoral prosthesisafter total hip arthroplasty; and the effects of different internal fixationsfor the treatment of fractures around femoral prosthesis after total hiparthroplasty were compared. RESULTS AND CONCLUSION: Theage, years, type of prosthesis and the stability of the prosthesis were therisk factors of fractures around femoral prosthesis after total hiparthroplasty, such as the fracture risk of uncemented prosthesis was higherthan that of the bone cement prosthesis. For the choice of internal fixationmethod for the treatment of fractures around prosthesis after total hiparthroplasty, shape memory alloy embracing fixcator could not damage thecortical bone around the prosthesis, and has the advantages of fixed solid,simple operation, less invasive and fewer complications, and so on, while thelocking compression plate combined with steel cable internal fixation has theadvantages of less trauma, little blood interference on the fracture fragmentsand fixed solid. Two kinds of internal fixation can obtain better clinicaltherapeutic effect, but the therapeutic effect of locking compression plateinternal. fixationis bet ter than that of the shape memory alloy embracing fixcator internalfixation.
摘要 目的:探讨Nexgen-LPS-Flex人工膝关节置换治疗重度膝关节退行性骨关节病临床疗效。方法: 回顾性分析2003年12月至2009年12月获得随访以上的126例(173膝)接受Zimmer 高屈曲后稳定(Nexgen-LPS-Flex)人工膝关节置换的重度退行性膝关节骨关节病患者的临床结果, 并采用HSS评分标准对其临床结果进行分析。结果:平均随访19个月(12~36月)。126例173个膝关节置换均手术顺利,每膝平均手术时间78.2±13.5分钟。4例(4膝)切口愈合障碍;确诊下肢深静脉血栓3例,均行介入治疗康复出院;1例出现伸膝滞缺,无神经血管损伤发生,无感染、 骨折、假体松动、脱位等并发症。股胫角为外翻5~7°,关节活动范围:术前平均(78.4±10.6)°,术后平均(112.8 ±18.6)°。173膝术前HSS评分平均(32.4±12.0)分,出院时为(87.9±10.9)分,均显著高于置换前(P〈0.01)。结论:Nexgen-LPS-Flex人工膝关节置换治疗重度膝关节退行性骨关节病早期临床效果满意,早期未发现有骨溶解、假体松动及衬垫严重磨损等并发症。