Mclauchlan入路髋关节置换的临床应用

目的探讨Mclauchlan入路髋关节置换的临床应用及其方法改良。方法2002年1月至2007年4月采用Mclauchlan切口入路行髋关节置换168例181髋，其中全髋置换122例135髋，半髋置换46例46髋。男性96例104髋，女性72例77髋；年龄29～90岁，平均62岁。术中用骨刀将大粗隆的骨膜及连带大粗隆上的一薄层骨皮质连同臀中肌股外侧肌一并掀起，依次切开臀小肌与关节囊，可以充分暴露髋臼与股骨上端。结果随访6～36个月，平均16个月。得到随访的106例均在术后6～8d开始逐步负重行走，髋外展肌力良好，除有1例因患肢术前短缩置换术后仍行走跛行外，其余患者均无跛行。Trendelenburg试验（-），手术大粗隆切口区无明显不适，x线片显示大粗隆骨皮质愈合良好。术后3个月时Harris评分平均94．53分，较术前提高了24．68分。结论采用Mclauchlan切口，手术视野良好、创伤小、出血少，前无股血管之顾，后无坐骨神经之忧，其上也避免了臀上神经的损伤，操作简单，手术时间短，值得推广使用。

The Clinical Application of Mclauchlan Incision Approach for Artificial Coxa Arthrosis Replacement

Objective Summarize the clinical experiences of the replacement of artificial coxa arthrosis with Mclauchlan approach.Methods Since January 2002 to April 2007 there had been 168 cases with 181 coxas:96 cases with 104 coxas for male and 72 cases with 77 coxas for female using Mclauchlan incision approach to replace coxa arthrosis.The age ranged from 29 to 90 years old with the average age of 62.These surgicals adopted Mclauchlan incision approaches,using bone knives to surge the periosteum of the great troch...