改良Watson-Jones手术入路行人工股骨头置换术

Artificial Femoral Head Replacement Through The Modified Watson-Jones Approach

目的 :探索一种简便、有效的手术入路行人工股骨头置换术。方法 :采用改良的Watson -Jones手术入路 ,即在原Watson -Jones手术入路基础上 ,皮肤切口向后弧度加大 ,不通过切断臀中肌及股外侧肌来显露术野 ,而是将其连同两者的腱性连接部向前侧翻转直至转子间线 ,来充分显露股骨大、小粗隆及髋关节。作者从 1994年 1月至 1998年10月采用此入路行人工股骨头置换术 86例。结果 :全组患者无手术死亡及术后感染。术后随访 6～ 12月 ,总优良率为 91.9%。其中有 17例患者术后发生轻度跛行 ,7例患者患肢缩短超过 2cm。无术后髋关节脱位病例。结论 :作者认为此手术入路有操作简便、安全、创伤小、暴露好 ,有利于假体定位、固定以及术后外展肌功能恢复快等优点 ,是一种较为理想的手术入路。

Objective:To explore a convenient and effective approach for artificial femoral head replacement.Methods:Artificial femoral head replacement was excised through the modified Watson-Jones approach.The approach was safeguarded middle gluteal muscle and lateral great muscle of thigh and conjunctive tendon integrity.Pulled these muscle forward from posterior to intertrochanteric line.Exposed greater and lesser trochanter and the hip.From January 1994 to October 1998,86 cases were treated artificial femoral head replacement with this approach.Result:there were no mortality nor infection.The follow-up period ranged from6-12 months.17 cases were slight limping,7 cases discrepany for more than 2cm.No one dislocation.Conclusion:process was exposed very safe,covenient,cleary and the operation field was widered with this approach,offers distinct advantage for orientation of the implant,insertion of cement.Clinical studies confirmed postoperative recovery of the normal power and function of the glutei and tenser fascia lata.