全髋关节置换术后早期脱位原因及处理

Causes and management of early dislocation after total hip arthroplasty

目的 探讨全髋关节置换术后早期脱位的原因及处理。方法 对 1996年 4月～ 2 0 0 1年 10月完成的 879例全髋关节置换术后发生脱位的 8例患者进行分析。结果 脱位发生在术后 1～ 2 5d ,由髋臼假体安置不当、股骨粗隆骨折、髋部肌肉松弛和康复锻炼不当造成。结论 术中选择适当入路、正确安放假体、适当修复软组织 ,术后指导患者进行功能锻炼 ,能有效地防止早期脱位的发生。

Objective To study the causes and management of early dislocation after total hip arthroplasty (THA). Methods To analyze eight cases of early postoperative dislocation in 879 THAs performed in April, 1996 to October, 2001. Results Dislocation occurred 1～25 days after operation and was caused by unsuitable positioning of acetabular components in two cases, by fracture of the great trochanter in one, by laxity of musculature around the hip in one and by malpractice in rehabilitation in four. Four of the eight cases were successfully reduced, while operation was necessary in the others. Conclusion Dislocation after THA can be effectively prevented by selection of appropriate operative approach, correct positioning of the prosthesis, proper repairing of the associated soft tissues, and instruction of rehabilitation .