预防人工全髋关节置换术后双下肢不等长的临床研究

Clinical Research of Prevention Inequality of Lower Limb after Total Hip Replacement

目的:探讨应用L形测径器均衡下肢长度以预防人工全髋关节术后双下肢不等长的临床效果。方法:2009年3月-2011年8月选用L形测径器术中测量及均衡单侧全髋关节置换患者83例,其中男49例,女34例,年龄46～82岁。术前常规模板X线测量及预测髋关节假体型号、位置,术后准确测量双下肢长度及随访观察。结果:83例术后均获3～29个月随访,平均18.5月。术前肢体长度差0～5mm的患者占7.2%;差5～10mm的占20.5%;差10～15mm的占38.6%;差15～20mm的占25.3%,大于20mm的占8.4%;通过平衡肢体长度差,术后双下肢长度差0～5mm的比例提高到34.9%,差5～10mm的比例为42.2%,差10～15mm的比例为14.5%,差15～20mm比例为6.0%,差异>20mm的比例为2.4%。结论:全髋关节置换术中利用L形测径器均衡下肢长度,结合术前模板测量,可有效地预防双下肢不等长。

Objective To study the clinical effect by measurement marked with L-shaped caliper for preventing the inequality of lower limb after total hip replacement.Methods From March 2009 to August 2011,83 patients who were measured with L-shaped caliper for preventing the inequality of lower limb in total hip replacement operation.There were 49 males and 34 females（aged from 46 to 82）.X ray was measured,the artificial hip＇s type and situation was calculated in advance.After operation,the real and accurate length of lower limbs were measured and all patients were followed up.Results All patients were followed up for 3 to 29 months（18.5 months on average）.Preoperatively,the lower limb＇s length discrepancy were 0 ～ 5mm in 7.2%,5～10mm in 20.5%,10～15mm in 38.6%,15～20mm in 25.3%,and more than 20mm in 8.4%.After operation,the length discrepancy were i mproved to 0～5 mm in 34.9%,5～10mm in 42.2%,10～15mm in 4.5%,15～20mm in 6.0%,and more than 20mm in 2.4%.Conclusion In total hip replacement operation,measurement with L-shaped caliper for preventing the inequality of lower limb combining with measurement before operation can efficiently prevent inequality of lower limb,it is proved to be a suitable alternative.