保留股方肌在人工髋关节置换术中对股骨距骨量的影响

Effect of the preserving quadratus femoris on the bone mass of femoral calcar in atificial hip arthroplasty

目的:观察后外侧入路人工髋关节置换术中保留股方肌对股骨距骨量的影响。方法:选取因股骨颈骨折需行人工髋关节置换术病人60例,随机分为观察组和对照组各30例,对照组术中切断股方肌,观察组术中保留股方肌。记录手术时间、术中出血量、术后12个月Harris髋关节功能评分。术后3、6、12、24个月随访病人采用外斜位X线摄片了解股骨距骨量变化情况。结果:2组的手术时间、术中出血量、术后12个月Harris评分差异均无统计学意义(P>0.05)。术后3、6、12个月股骨距骨量比较差异均无统计学意义(P>0.05),术后24个月时,对照组股骨距骨量丢失比例高于观察组(P<0.05)。结论:在后外侧入路人工髋关节置换术中通过对股方肌的保留,可以延缓股骨距的骨质吸收,有效地减少股骨距的骨量丢失。

Objective： To observe the effects of the preserving quadratus femoris on the bone mass of femoral calcar in atificial hip arthroplasty. Methods： Sixty femoral neck fracture patients treated with artificial hip arthroplasty were randomly divided into the observation group and control group（ 30 cases each group）. The control group was treated with cutting off quadratus femoris,and the observation group was treated with preserving quadratus femoris. The operation time,blood loss and Harris hip score in two groups after12 months of operation were observed. The bone mass of femoral calcar in two groups were investigated using craniocaudal oblique of45-degree X-ray film after 3,6,12 and 24 months of operation. Results： The differences of the operation time,blood loss and Harris hip score after 12 months of operation between two groups were not statistically significant（ P〉0. 05）. The differences of the bone mass of the femoral calcar after 3,6 and 12 months of operation between two groups were not statistically significant（ P〉0. 05）,and the loss bone mass of femoral calcar after 24 months of operation in control group was higher than that in observation group（ P〈0. 05）.Conclusions： The preserving quadratus femoris in artificial hip arthroplasty may reduce the bone absorption of femoral calcar,and effectively decrease the osteolysis of femoral calcar.