髋关节置换术后翻修的治疗

Repair surgery after hip replacement

目的 探讨股骨皮质骨开窗术在髋关节翻修术中的效果.方法 搜集髋关节翻修手术治疗的患者28例（28髋）,均采用股骨皮质骨开窗术进行翻修,结合术前、术后髋关节Harris评分,对股骨皮质骨开窗术治疗效果进行分析.结果 28例患者术后均获得随访,随访期间无再次翻修病例.股骨皮质骨开窗平均长度为3.4 cm,宽度为1.2 cm.术后3～5个月皮质骨瓣开始与周围骨纤维愈合.结论 股骨皮质骨开窗术具有操作简单、创伤小、并发症少等优点;在髋关节术后翻修治疗中,可在直视下彻底取出股骨髓腔远端稳定固定的骨水泥;开窗不影响股骨翻修假体植入后的稳定性,也不影响股骨近端骨质血供和肌肉附着,术后可早期行功能康复锻炼,是一种安全可靠的翻修技术,值得临床推广应用.

Objective To explore the effect of the cortical windowing of the femoral diathesis in hip revision surgery. Methods Collected 28 patients（28 Keens） who received hip revision surgery; all of them were repaired by the cortical windowing of the femoral diathesis; according to the articulation coaxes Harris score before and after surgery,analyzed the treatment effect of the cortical windowing of the femoral diathesis. Results All 28 patients got follow-up visit, no case needed repair again. The length of thighbone of integument ale cortical windowing was 3.4 cm, the extent was 1.2 cm. After surgery, integument ale and the around bone fibers closed up. Conclusion The cortical windowing of the femoral diathesis has easy operation, little hurt, and few complication. In hip revision surgery, it can look clear when take out the bone cement in thighbone pulp cavity. It is far-end stationary, and has no infection in restoration; it also cause no infection from the blood supply and muscle insertion in thighbone near-end sclerotic. The patients can be train early after surgery. It＇s a safe and reliable repair surgery, so it deserves to generalize in clinical medecine.