髋关节置换术中下肢不等长的预防

Prevention of the leg-length discrepancy during the total hip replacement

目的探讨预防或减少髋关节置换术后下肢不等长的有效方法。方法选取需行髋关节置换的患者40例,随机分为实验组和对照组,每组20例。术前测量双下肢长度差异值,实验组术中使用自行设计的下肢等长测量装置,根据术前测量值调节手术侧肢体长度;对照组采用常规手术方法。术后第2天测量患者双下肢长度差异值。术后6个月通过问卷调查,对患者进行满意度调查及患髋的Harris评分。结果术后6个月两组患者均满意,但在满意程度上存在差异;实验组与对照组术后双下肢长度差异值比较,差异有统计学意义(P<0.05);实验组与对照组术后患髋Harris评分,差异无统计学意义(P>0.05)。结论在髋关节置换术中使用下肢等长测量装置,可有效减少或消除髋关节置换术后双下肢不等长,提高患者的满意度。

Objective To explore an effective method that can reduce or prevent the leg-length discrepancy during the total hip replacement.Methods 40 patients who need be operated the hip replacement were enrolled.They were randomized into the experimental group（20 patients） and the control group（20 patients）.The patients′ leg-length was metered before the total hip replacement.In the experimental group,the self-designed device of leg-length isometry was used during total hip replacement.Based on the metered result before the operation,the patients′ leg-length was adjusted in the operation to reduce or prevent the leg-length discrepancy after total hip replacement.In the control group,the new method wasn′t used during total hip replacement.In the 2nd day postoperation,all patients′ bilateral leg-length was metered.Six months postoperation,all patients were asked to fill in the questionnaire about the satisfaction and the Harris hip score.Results Six months after the operation,all patients were satisfied with the hip replacement,but the extent of the satisfaction of the experimental group was superior to the control group.The patients′ bilateral leg length was significant in statistics the difference between the control group and the experimental group（P0.05）.The Harris hip score wasn′t significant in statistics the difference between the control group and the experimental group（P0.05）.Conclusions The use of the device of leg-length isometry in total hip replacement can effectively decrease the leg-length discrepancy and improve patient satisfaction.