全髋关节置换治疗髋部复杂性骨折切开复位内固定术后并发创伤性骨性融合疗效研究

Therapeutic effect of THA on secondary traumatic hip arthrodesis after internal fixation

目的:分析C型臂X线机透视下全髋关节置换术(THA)对髋部骨折内固定术后出现髋关节创伤性骨性融合的治疗效果。方法:采用回顾性研究,收集21例髋部骨折内固定术后出现髋关节创伤性骨性融合患者的临床资料,均于C型臂X线机透视下行THA治疗。术后均进行随访,采用Harris髋关节评分标准评估患者手术前后髋关节功能的改善情况。结果:本组患者均顺利进行THA治疗,手术过程中未出现血管损伤、神经损伤或骨折等相关并发症。术后随访6~24个月,平均(19.34±1.13)个月。末次随访时平均Harris评分为(92.14±4.04)分,较术前(49.97±4.27)分显著升高(P<0.01)。结论:髋部骨折内固定术后出现髋关节创伤性骨性融合的患者应用THA治疗可获得良好的疗效,且通过C型臂X线机透视可进行准确定位,采用合理的角度选择并安装合适的生物型人工髋关节假体,最终可获得满意的治疗效果。

Objective:To analyze the therapeutic effect of total hip arthroplasty(THA)under C-arm X-ray fluoroscopy on traumatic hip fusion after internal fixation of hip fracture.Methods:A retrospective study was conducted to collect the clinical data of 21 patients with traumatic bone fusion of hip joint after internal fixation of hip fracture in our hospital,all of whom were treated with THA under C-arm X-ray fluoroscopy.The improvement of hip function before and after operation was assessed by Harris hip score.Results:All the patients in this group were successfully treated with THA,and no vascular injury,nerve injury or fracture or other related complications occurred during the operation.Postoperative follow-up was 6-24 months,with an average of(19.34±1.13)months.At the last follow-up,the mean Harris score was(92.14±4.04),which was significantly higher than that before surgery(49.97±4.27)(P<0.01).Conclusion:Patients with traumatic bone fusion of hip joint after internal fixation of hip fracture can obtain a good therapeutic effect by THA,and accurate positioning can be achieved by C-arm X-ray fluoroscopy,and appropriate biological artificial hip prosthesis can be selected and installed at a reasonable Angle,so as to obtain satisfactory therapeutic effect.