人工髋关节置换后的双下肢不等长

Limbs length discrepancy after artificial hip replacement

背景:双下肢不等长是人工髋关节置换后常见的并发症之一,采取综合措施预防双下肢不等长可获得较好的临床效果。目的:评价综合措施预防全髋关节置换后双下肢不等长的临床应用效果。方法:对江苏省常熟市第二人民医院骨科128例136侧髋关节置换采用综合措施预防术后双下肢不等长的临床病例进行分析,采用术前肢体长度评估、术前模板计划、术中测量及综合调整的方法预防全髋关节置换后双下肢不等长,并检索国内、外数据库2002至2011年收录人工髋关节置换后双下肢不等长的相关研究文献,基于数据库检索的结果进行数据分析。结果与结论:128例患者治疗前双下肢不等长在0-4.0cm,平均1.6cm,全髋关节置换后7d进行肢体长度测量,2例患者双下肢长度差距1.0-2.0cm,12例患者双下肢长度差距0.5-1.0cm,55例患者双下肢长度差距0.3-0.5cm,59例患者双下肢长度差距<0.3cm。平均差距0.4cm。临床病例分析可以看出采用综合措施可以有效预防全髋关节置换后双下肢不等长。国内、外数据库检索结果分析可以看出,国内、外作者发表该领域相关研究文献均不多,但国外基金资助文献数量明显多于国内基金资助文献数量。

BACKGROUND： Limbs length discrepancy is a common complication after hip arthroplasty, comprehensive measures for preventing limbs length discrepancy can obtain the better clinical results. OBJECTIVE： To evaluate the clinical application effect of comprehensive measures for preventing limbs length discrepancy after total hip arthroplasty. METHODS： 128 patients （136 hips） were selected from the Department of Orthopedics, Changshu No.2 People’s Hospital for analysis, and all the patients received the comprehensive measures to prevent the limbs length discrepancy after total hip arthroplasty. Preoperative limb length assessment, preoperative template plan, intraoperative measurement and comprehensive adjustments were performed to prevent the limbs length discrepancy after total hip arthroplasty. The articles related to the limbs length discrepancy after total hip arthroplasty from 2002 to 2011 were searched in the domestic and foreign databases, and the data were analyzed based on the results of database searches. RESULTS AND CONCLUSION： The limbs length discrepancy before treatment of 128 patients was range between 0-4.0 cm, averagely 1.6 cm. The length of limbs was measured at 7 days after total hip arthroplasty, and found that 2 patients have the limbs length discrepancy of 1.0-2.0 cm, 12 patients have the limbs length discrepancy of 0.5-1.0 cm, 55 patients have the limbs length discrepancy of 0.3-0.5 cm, and 59 patients have the limbs length discrepancy 0.3 cm. The average limbs length discrepancy was 0.4 cm. Clinical analyses showed that comprehensive measures can prevent the limbs length discrepancy after total hip arthroplasty effectively. The results of domestic and foreign databases retrieval showed that the domestic and foreign literatures in this field were rare, but the number of foreign foundation supported literatures was more than that of domestic foundation supported literatures.