人工全髋关节置换术后脱位的原因探讨及防治

目的：探讨人工全髋关节置换术(THA)后髋关节脱位的易发因素、治疗方法及预防措施。方法：对7例THA术后髋关节脱位患者的临床资料进行回顾性分析。结果：7例患者中采用手法复位、外展皮牵引6例，切开复位1例。术后经3年随访，5例未再发生脱位；1例患者术后并发多发性脑梗塞，患侧臀中肌无力，反复出现脱位而放弃治疗；1例患者牵引治疗出院后再次出现脱位，入院行翻修手术，术后随访3年未再出现脱位。结论：全髋关节术后脱位主要是由于术前、术中、术后因素综合影响术后髋关节假体的稳定性．其中术中假体安装位置不当及术后周围软组织失衡是术后髋脱位的主要原因，围手术期过程中积极的预防可减少术后脱位发生率。

Study on causes of dislocation after total hip arthroplasty and clinical prevention and treatment

Objective: To investigate the mechanism of dislocation after total hip arthroplasty and provide its clinical prevention and treatment. Methods: Seven patients with dislocation after total hip arthroplasty in our hospital from 1996 to 2003 were analysed. Results: Six patients with dislocation after total hip arthroplasty were not operated, one patient was treated by operation. Five patients in reduction showed good result s and poor in 2 patients. Conclusion: Uncorrected fix prosthesis and unbalanced soft tissue are major causes of dislocation after total hip arthroplasty. Prevention measures should be positively taken in perioperative periods.