改良Hardinge入路人工全髋关节置换术中两种肢体长度测量方法比较

The comparison of two kinds of limb length measurement in total hip arthroplasty with modified hardinge approaches

目的分析在改良Hardinge入路人工全髋关节置换术中两种肢体长度测量方法在双下肢等长效果中的比较。方法回顾性分析2015年1月~2017年5月在我院行初次单侧改良Hardinge入路人工全髋关节置换术151例患者的临床病例资料,术中采用两种肢体长度测量方法,其中84例采用X线健侧对照法(A组),67例采用克氏针定位法(B组)。比较两组患者的手术时间、术中出血量、术后双下肢长度差、双下肢不等长的发生率、术后住院时间和髋关节功能Harris评分等方面的差异。结果 151例患者均完成随访。A组的手术时间[(107.32±12.01)min vs(94.56±15.39)min]较B组长,差异具有统计学意义(P<0.05)。但A组术后双下肢长度差[(1.08±0.52)mm vs(3.79±1.54)mm]较B组小,差异具有统计学意义(P<0.05)。而两组在术中出血量、双下肢不等长的发生率、术后住院时间和髋关节功能Harris评分等方面的差异无统计学意义。结论上述的两种方法中X线健侧对照法(A组)较克氏针定位法(B组)在下肢长度控制方面有更为精确的优势,但其术中所用时间较B组长。

Objective To compare the effectiveness of two kinds of limb length measurement in total hip arthroplasty （THA） with modified Hardinge approaches on equal length of lower extremities. Methods Clinical records of 151 patients who had been through one-side THA with modified Hardinge approaches for the first time in our hospital from January 2015 to May 2017 were retrospectively analyzed. Two limb length measurements were applied： 84 patients were mea- sured using X-ray normal side control （group A） and 67 patients were measured using location method of Kirschner pin （group B）. The operation duration, blood loss during operation, length difference of lower limbs, the incidence of unequal length of lower limbs, hospitalization time and Harris scores of hip function were compared between two groups. Results All of 151 patients completed the follow-up visit. The duration of operation in group A was statistically longer than that in group B[（107.32±12.01） min vs （94.56±15.39） min）] （P〈0.05）. The length difference of lower limbs in group A was significantly smaller than that in group B[（1.08±0.52） mm vs （3.79±1.54） mm）] （P〈0.05）. The blood loss during operation, the incidence of unequal length of lower limbs, hospitalization time and Harris score of hip function in two groups were not statistically different. Conclusion Between two methods mentioned above, X-ray normal side control （group A） was more accurate than the location method of Kirschner pin（group B） in length control of lower limbs, but it took longer duration of operation than group B.