减小髋臼杯外展角预防偏瘫患者全髋关节置换后的假体脱位

Prevention of prosthesis dislocation in hemiplegic patients subjected to total hip replacement by decreasing the abduction angle of the acetabulum

背景：目前关于偏瘫患者股骨颈骨折关节置换后的脱位率报道差别很大。目的：通过减小外展角降低老年偏瘫患者患侧股骨颈骨折关节置换后的脱位率。方法：回顾性分析采用人工全髋置换治疗偏瘫侧股骨颈骨折19例患者资料。结果与结论：患者随访期为3个月~7年,平均4年3个月。除2例置换后2年内因其他疾病死亡外,所有伤口均一期愈合,无切口感染,无髋关节脱位,置换后3个月参照Harris评分标准,其中优5例,良12例,优良率达89%。说明通过减小髋臼外展角是预防偏瘫患者股骨颈骨折全髋关节置换后脱位较可行的方法。

BACKGROUND： Currently reports on dislocation rate of joint replacement in hemiplegic patients with femoral neck fracture are different. OBJECTIVE： To decrease the abduction angle can decrease dislocation rate in elderly hemiplegic patients with side of the femoral neck fractures after joint replacement. METHODS： Date of 19 patients who using total hip replacement for the treatment of hemiplegic side femoral neck fracture were retrospective reviewed. RESULTS AND CONCLUSION： All the patients were followed-up from 3 months to 7 years postoperatively （average of 4 years and 3 months）. There were no infection and hip joint dislocation in all the patients whose wounds were healed except two patients died for other diseases at 2 years postoperation. At 3 months postoperation, Harries hip score showed excellent and good rate was 89%, evaluation excellent for 5 and good for 12. It is indicated that decreasing the abduction angle of the acetabulum during the joint replacement to prevent the dislocation of hip joint is a feasible method.