偏心距重建对股骨颈骨折关节置换术后恢复的影响

目的 探讨股骨颈骨折行人工关节置换术重建股骨偏心距(FO)对患者髋关节功能Harris评分及髋关节活动度的影响.方法 2004年2月至2005年10月对47例单侧股骨颈骨折行人工髋关节置换术的患者进行随访.随访时摄X线片测量,对比患侧与健侧FO.分析术后FO与患肢髋关节Harris评分及髋关节活动范围的相关性,对全髋关节置换术和人工双极头置换术的FO重建率进行χ2检验.结果 FO绝对值大小与患侧髋关节功能Harris评分高低尢相关关系(r=0.23,P=0.1 18),是否进行FO重建在髋关节功能Harris评分方面差异有统计学意义(t=7.25,P＜0.001)髋关节外展范围与FO存在明显正相关性(r=0.80,P＜0.001),全髋置换术及人工双极头置换术的FO重建率差异无统计学意义(χ2=0.13,P＞0.05).结论 股骨颈骨折人工髋关节置换术中重建FO有助于术后髋关节功能的恢复.FO的重建能影响髋关节的外展范围,但与术式选择(全髋置换术或人工双极头置换术)无关.

Effect of femoral offset on hip joint function reconstruction after arthroplasty in femoral neck fractures

Objective To study the effect of femoral offset reconstruction ON the Harris hip score and the hip ROM (range of motion) after artificial hip replacement in femoral neck fractures. Methods Follow-ups were conducted for 47 patients who had undergone artificial hip replacements for their unilateral femoral neck fractures. We took X-ray pictures to compare the femoral offsets at the affected and unaffected hips. The operated hips were evaluated by the Harris hip score. Statistical analyses were performed with SPSS l2.0 software. Results The Harris hip score of the operated hip was positively related to femoral offset reconstruction(t=7.25,P＜0.001).There was a significant and positive correlation between femoral offset and the hip abductor ROM(r=0.80,P＜0.001).The rate of femoral offset reconstruction had no significant difference between total hip arthroplasty and bipolar hip arthroplasty (χ2=0,P＞0.05).Conclusions Reconstruction of femoral offset after artificial hip replacement in the femoral neck fractures can improve funetional recovery and ROM of the hip. Femoral offset reconstruction is uncorrelated to the selection of total hip arthroplasty or bipolar hip arthroplasty.