内收肌切断预防全髋置换术后脱位

CLINICAL RESEARCH OF ADDUCTOR CUT OFF TO PREVENT DISLOCATION AFTER REPLACEMENT OF TOTAL HIP

目的:探讨成人股骨头坏死施行全髋置换术时将内收肌切断在预防术后脱位的作用。方法:将38例成人股骨头坏死施行全髋置换术病例随机分两组,甲组为内收肌切断组16例,乙组为不切断内收肌组22例,22例股骨颈骨折施行全髋置换术作对照为丙组。手术均由同一关节手术组医生操作,所用假体为合资或国产压配型。结果:甲、丙组未发生术后脱位,乙组2例发生后脱位,1例在麻醉下手法复位,另1例施行开放复位。乙组的脱位发病率为9%(2/22),明显高于甲、丙两组。结论:成人股骨头坏死病例,尤其病程较长、内收肌挛缩、患肢短缩者,在施行全髋置换术时将紧张的内收肌切断松解,可以改善髋周围肌力不平衡状况,便于术后髋外展体位放置,从而降低术后脱位的发生率。

Objective: To approach the effect of adductor cut off to prevent dislocation after replacement of total hip in adult femoral head necrosis.Methods:38 cases of patients were divided into two groups, grouop A (16 cases, adductor cut off ), group B (22 cases, not cut). And group C(22 cases of femoral neck fracture with replacement of total hip) were added for contrast. They were operated by the same group of doctors, andprosthesis used come from joint venture or national company. Results: It showed that dislocations postoperative were zero in group A and group C,two cases in group B (one by manipulative reduction with anesthesia, another handleded open ). Incidence rate of dislocation in group B was 9%and super to those of two others. Conclusion: It indicated that in replacement of total hip tense adductor cut off could improve muscular imbalanceof hip environment, benefit hip abducting and lower incidence rate of dislocation postoperative , for those who had adult femoral head necrosis withlonger course of disease, tense adductor and shorter affected extremity.