后外侧入路高脱位髋关节假体重建软组织处理

Posterolateral Approach for High Dislocation of Hip Prosthesis Reconstruction of Soft Tissue

目的：探讨高脱位髋关节发育不良假体重建的软组织处理方法.方法：对11例高脱位髋关节发育不良者行初次单侧全髋关节假体重建术,其中男3例,女8例;平均年龄52.5岁（48～71岁）.Crowe分型III型9髋,IV型2髋.后外侧入路,依层次松解显露,髋臼基床及股骨髓腔处理,髋臼和股骨假体安装于适当位置后行必要的软组织重建.结果：术后11例平均随访时间15个月（6～24个月）,髋关节疼痛消除,畸形步态基本矫正,关节活动度增加,功能得到明显改善.Harris评分从术前平均34.1分提高到术后平均86.6分,近期优良率为90.9%.结论：术中避免盲目松解并行必要的软组织重建,可最大限度地减少相关并发症.

Objective ： To explore the soft tissue reconstruction in implant treatment for the high - dislocation of the hip dysplasia. Methods： The primary unilateral total hip arthroplasty was performed in 11 patients （ 3 males, 8 females, a mean age of 52.5 years ） with high - dislocation of the hip dysplasia . According to Crowe classification, 9 hips were classified as type Ⅲ and 2 hips as type Ⅳ. All patients revealed according to anatomical level by posterlateral approach, the acetabular and femoral medullary cavity were treated, the soft tissue reconstruction was performed after the aeetabular and femoral were properly fixed. Results： 11 patients were followed up for the average of 15 months （6 -24months） , hip joint pain was eliminated , abnormal gait was almost corrected, joint mobility increased and function improved significantly. The follow -up showed that Harris scale increased from34.1 point preoperatively to 86.6 points, the effective rate was 90.9%. Conclusions：The need to avoid blind release for the soft tissue and perforul reconstruction of the soft tissue can minimize the complications.