老年患者人工股骨头置换术前牵引及手术入路

Preoperative Traction and Approach of Artificial Femoral Head Replacement for Senile Patient

目的:探讨老年患者人工股骨头置换手术治疗时术前牵引及手术入路的选择对疗效的影响。方法:回顾性分析152例老年患者人工股骨头置换手术治疗的临床资料。结果:86例经髋关节前外侧入路手术,其中60例术前采用下肢皮牵引带牵引,26例术前采用骨牵引;66例经髋关节外侧入路手术,其中51例术前采用下肢皮牵引带牵引,15例术前采用骨牵引;术中复位均较容易;术后优良者占95.1%,很好者占3.7%,好者占1.2%,十年内无后脱位和修正者。结论:老年患者人工股骨头置换手术选择前外侧入路和外侧入路对疗效影响无差异,外侧入路比前外侧入路操作简单、创伤小;股骨头及股骨颈无明显短缩或头颈骨折后2周内手术的老年患者,人工股骨头置换术前采用下肢皮牵引比骨牵引更合适。

Objective： To discuss curative effect in preoperative traction and approach of artificial femoral head replacement for senile patient. Methods： 152 cases underwent artificial femoral head replacement were retrospectively studied. Results： The intraoperative reposition of 60 cases of skin traction bandage in lower extremity and 26 of skeletal traction were easier in 86 cases of anterolateral approach to the hip joint; The intraoperative reposition of 51 cases of skin traction bandage in lower extremity and 15 of skeletal traction were easier in 66 cases of anterolateral approach to the hip joint. The postoperative excellent rate was 95.1%,better rate 3.7%and good rate 1.2%.There were no one case taken backward dislocation and corrected in 5 year. Conclusion： The curative effect in anterolateral approach and lateral approach of artificial femoral head replacement for senile patient was not obvious differentiate;lateral approach was more easy and more less traumatic than anterolateral approach; Preoperative skin traction should be more satisfactory than skeletal traction in artificial femoral head replacement for no crispatura caput femoris and collum femoris of senile patient or operated senile patient within 2 week after fracture.