股外侧U形切口全髋置换术治疗双侧骨性强直髋关节

目的 :介绍强直性脊柱炎合并双侧骨性强直髋关节的全髋置换手术方法。方法 :采用股外侧U形切口入路 (改良Ollier手术 ) ,切断宽筋膜、髂胫束和大转子 ,自肌肉间隙分离暴露髋关节 ,不需要横断肌肉 ,损伤小、恢复快。截断骨性融合的髋关节、挖髋臼和镶入假体都能在直视下进行 ,较方便。只需要将大转子复位钢丝固定 ,并将切断的宽筋膜用 8字形缝合 ,防止缝线撕裂 ,即可达到术后早期下床活动的目的。结果 :本组 2 5例采用此方法的患者 ,术后恢复顺利 ,伤口愈合良好 ,都能早期下床活动未见有再脱位的现象发生。结论 :股外侧U形切口全髋置换术治疗双侧骨性强直髋关节 ,能达到暴露清楚、操作方便的要求。值得推广应用。

U shape approach of lateral femur for the treatment of bilateral hip ankylosing arthritis with total hip replacement

Objective:To introduce the surgical methods of total hip replacement for treating the ankylosing spondylitis complicated bilateral hip bony ankylosis.Method:Adopt of the U shape approach of lateralfemur (improved Ollier operation) cut off the fascia lata,iliotibial tract and greater trochanter then from muscular space separated and exposed the hip and need not severing the muscles.Severe the bony ankylosis hip,under direct vision to dig the acetabulum and replace the prosthesis will be quite convenience,after the prosthesis replaced only to reduced the greater trochanter and fixated it with wire and suture the severed fascia lata with "8"-shape suture to avoid its tearing.Result:Twenty-five patients of this group were treated by this method,post operation had a successful recovery and incision achieved a better union,all of the patients could early resume movement and did not show redislocation.Conclusion:Adopt this U shape approach of lateral femur can expose the operation field sufficiently and conveniently.It's worth to popularize this method.