预防人工全髋关节置换术后双下肢不等长的临床疗效分析

目的分析应用L形测径器均衡下肢长度以预防人工全髋关节术后双下肢不等长的临床效果。方法 2009年3月至2011年8月选用L形测径器术中测量及均衡单侧全髋关节置换患者83例,男49例,女34例,年龄46～82岁。术前常规模板X线测量及预测髋关节假体型号、位置,术后准确测量双下肢长度及随访观察。结果 83例术后均获3～29个月随访,平均18.5个月。术前肢体长度差异≤5mm的患者占7.2%;5mm<差异≤10mm的占20.5%;10mm<差异≤15mm的占38.6%;15mm<差异≤20mm的占25.3%,差异>20mm的占8.4%;通过平衡肢体长度差,术后双下肢长度差异≤5mm的比例提高到34.9%,5mm<差异≤10mm的比例为42.2%,10mm<差异≤15mm的比例为14.5%,15mm<差异≤20mm比例为6.0%,差异>20mm的比例为2.4%。结论全髋关节置换术中利用L形测径器均衡下肢长度,结合术前模板测量,可有效地预防双下肢不等长。

Clinical efficacy of L-shaped caliper on prevention of inequality of lower limbs after total hip replacement (THR)

Objective To explore the clinical efficacy of L-shaped caliper on prevention of inequality of lower limbs after total hip replacement (THR) by balancing the lengths of low limbs in surgery. Methods From March 2009 to August 2011, 83 patients (males=49, females=34; ages: 46～82) were used L-shaped caliper to measure and balance the lengths of low limbs in total hip replacement (THR). The conventional plate X ray was used to measure and predict the size and location of artificial hip before surgery, and the lengths of low limbs were accurately mea - sured after surgery. Furthermore, a following-up was then performed. Results A following-up of 3 months to 29 months (mean: 18.5 months) was done in 83 patients. The length discrepancy of 0～5 mm was found in 7.2%, of 5～10 mm in 20.5%, of 10～15 mm in 38.6%, of 15～20 mm in 25.3% and of > 20 mm in 8.4% among all patients before surgery. Nevertheless, the length discrepancy of 0～5 mm was found improved to 34.9%, of 5～10 mm in 42.2%, of 10～15 mm in 4.5%, of 15～20 mm in 6.0% and of >20 mm in 2.4%. Conclusion In THR, L-shaped caliper was used to balance the lengths of low limbs, which may effectively prevent inequality of lower limbs when combined with plate measurement before surgery.