粗隆柄型人工股骨头置换术截骨导向器研制及应用

Development and application of an osteotomy guider for intertrochanteric-type femoral stem of hip hemiarthroplasty

[目的]介绍股骨粗隆间骨折关节置换术截骨导向器设计、临床应用技术与初步结果。[方法]2016年2月—2017年12月,采用粗隆柄型人工股骨头置换术治疗的77例股骨粗隆间骨折患者,其中39例术中采用自行研制的截骨导航工具(导向器组),38例采用原配的截骨模板(模板组)。比较两组临床资料。[结果]77例均获得随访,随访时间为平均(18.15±4.76)个月。导向器组截骨成型的操作时间、总手术时间均较模板组短,术中出血量较模板组少,差异有统计学意义(P<0.05)。术后1年Harris评分、下床活动时间两组差异无统计学意义(P>0.05)。[结论]在粗隆柄型股骨头置换术治疗的手术过程中,使用此自制的截骨导向器可使多向不确定的截骨程序变成了可控的导向通道操作,从而提高操作效率与精确性。

[Objective]To introduce the design,application and primary clinical outcomes of an osteotomy guider for the intertrochan⁃teric-type femoral stem of hip hemiarthroplasty.[Methods]From February 2016 to December 2017,a total of 77 elderly patients under⁃went hip hemiarthroplasty with intertrochanteric-type femoral stem for intertrochanteric fractures.Of them,39 patients had operation per⁃formed with the self-developed osteotomy guider,while the remaining 38 patients were with the conventional osteotomy template.The clini⁃cal documents were compared between the two groups.[Results]All 77 cases were followed up for an average of(18.15±4.76)months.The guider group proved significantly superior to the template group regarding osteotomy time,total operation time and intraoperative blood loss(P<0.05).However,there were no statistical differences in the time to return ambulation and Harris scores at 12 months postoperatively be⁃tween the two groups(P>0.05).[Conclusion]During hip hemiarthroplasty with intertrochanteric-type femoral stem for intertrochanteric fractures,using the self-developed osteotomy guider does enhance the efficiency and accuracy of surgical operation.