牵引床辅助直接前侧入路半髋关节置换术的并发症分析

Complications analysis of hemiarthroplasty through direct anterior approach assisted by the traction table

目的探讨牵引床辅助直接前侧入路半髋关节置换术治疗高龄老年股骨颈骨折的并发症及防治方法。方法回顾性分析2019年6月至2021年8月采用牵引床辅助DAA-HA治疗的196例高龄股骨颈骨折患者临床资料。分析患者并发症的发生原因、治疗方法及预后。结果所有患者平均随访时间21.6个月(12~30个月),发生并发症25例。其中11例(5.6%)发生股外侧皮神经损伤,6例(3.1%)切口渗液,5例(2.6%)假体周围骨折,3例(1.5%)双下肢不等长。随访期内,未发生假体脱位、假体松动、感染等其他并发症。结论牵引床辅助DAA-HA治疗高龄老年股骨颈骨折过程中存在股外侧皮神经损伤、切口渗液、假体周围骨折、双下肢不等长等并发症。规范手术操作流程,提升手术技术,重视患者病情及术后康复过程可减少并发症的发生。

Objective To explore the complications and prevention methods of hemiarthroplasty(HA)through direct anterior approach(DAA)assisting by the traction table for the treatment of femur neck fractures in elderly patients.Methods A The clinical data of 196 elderly patients with femur neck fractures treated with HA through DAA were retrospectively analyzed in our hospital from June 2019 to August 2021.The causes,treatment and prognosis of complications were analyzed in each case.Results All patients were followed up for 12 to 30 months,averagely 21.6 months,and complications were occurred in 25 cases.Among them,11 cases(5.6%)had lateral femoral cutaneous nerve(LFCN)injury,6 cases(3.1%)had incisional oozing,5 cases(2.6%)had periprosthetic fractures,3 cases(1.5%)had limb length discrepancy.There was no dislocation,prosthesis loosening,infection or other complications during the follow-ups.Conclusions There are many complications such as LFCN injury,incisional oozing,periprosthetic fracture,limb length discrepancy during the treatment of femoral neck fractures in elderly with DAA-HA by assistance of the traction table.Standardization of surgical procedures,improving the surgical technique,paying attention to patient's condition and rehabilitation can reduce its complications.