股骨头中心到大转子顶点测量法在股骨颈骨折患者全髋关节置换术中的应用价值

Value of Measurement from Center of Femoral Head to Apex of Greater Trochanterin Patients with Femoral Neck Fracture After Total Hip Arthroplasty

目的探讨股骨头中心到大转子顶点测量法在股骨颈骨折(FNF)患者全髋关节置换术(THA)中的应用价值。方法选取周口骨科医院2020年1月至2022年12月收治的300例FNF患者,随机分为常规对照组和研究组,各150例。常规对照组术中接受双侧髌骨平齐法平衡双下肢长度。研究组术中接受股骨头中心到大转子顶点测量法平衡双下肢长度。比较两组围手术期指标、双下肢相对长度差值、双下肢不等长(LLD)发生率、并发症发生率、髋关节功能(Harris评分)、日常生活能力(改良BI指数)。结果研究组术中出血量、手术用时及住院时间与常规对照组比较,差异无统计学意义(P>0.05);术后6个月,研究组双下肢相对长度差值和LLD发生率低于对照组(P<0.05);研究组术后6个月髋关节Harris评分、改良BI指数高于常规对照组(P<0.05);研究组术后并发症发生率与常规对照组比较,差异无统计学意义(P>0.05)。结论THA术中用股骨头中心到大转子顶点测量法平衡双下肢长度,可减少术后LLD发生,有效改善患者术后髋关节功能,提高术后日常生活能力。

Objective To investigate the value of measurement from the center of femoral head to apex of greater trochanter in patients with femoral neck fracture(FNF)after total hip arthroplasty(THA).Methods A total of 300 patients with FNF were selected from Zhoukou Orthopaedic Hospital from January 2020 to December 2022,and they were randomly divided into conventional control group and research group,150 cases in each group.In the conventional control group,the length of both lower limbs was balanced by bilateral patella leveling.In the research group,the length of the lower limbs was balanced by the measurement from the center of the femoral head to the apex of the greater trochanter.Perioperative indexes,relative length difference of lower limbs,incidence of leg length discrepancy(LLD),incidence of complications,postoperative rehabilitation(fracture healing X-ray score,weight bearing of affected limb),hip function(Harris score),and ability of daily living(improved BI index)were compared between the two groups.Results There were no differences in the intraoperative blood loss,operation time and hospital stay between the research group and conventional control group(P>0.05).After 6 months of surgery,the relative length difference of lower limbs and the incidence of LLD in the research group were lower than those in the conventional control group(P<0.05).After 6 months of surgery,the hip Harris scores and the improved BI index in the research group were higher than those in conventional control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the research group and conventional control group(P>0.05).Conclusion Using the measurement method from femoral head center to apex of greater trochanter to balance the length of both lower limbs during THA can reduce the incidence of postoperative LLD,effectively improve the hip function of patients after surgery,improve the ability of daily living after surgery.