髋关节置换术人工股骨柄置入位置不佳的预防

目的探讨人工髋关节置换股骨柄位置不佳的原因及预防方法。方法对1 420髋人工髋关节置换术病例进行分析,特别对手术操作中在股骨端开髓与扩髓方法的操作要点予以叙述。结果 56髋股骨柄位置不佳,其中41髋造成股骨炳松动,32髋出现患髋疼痛。26髋需做翻修手术,52髋开髓位置方法错误,54髋扩髓不充分。结论为减少人工髋关节置换手术后远期并发症,股骨柄置入在股骨干髓腔内的位置必须在髓腔中轴线上。开髓前要彻底剥离大粗隆内侧面软组织,以便开髓器靠近其基底部。扩髓时髓腔锉外侧面要紧靠大粗隆内侧面反复充分扩髓。

Prevention of poor location of artificial femoral stem in hip arthroplasty

Objective To discuss the reasons and prevention of femoral stem displacement(FSD) following hip arthroplasty.Method 1 420 cases of hip replacement were analyzed for studying the FSD.Specifically,the critical procedures in opening and expanding of the femoral cavity were investigated.Results Fifty six cases of FSD occurs within five years of follow up,which cause 41 cases of loosening,32 cases of hip pain,and 26 cases of secondary repairing operation.Fifty two cases of inappropriate opening location and fifty four cases of inadequate expansion were identified.Conclusion In order to reduce long-term complications after hip replacement surgery,femoral stem must be positioned precisely in the central axis of femoral intramedullary canal.Before opening the femoral cavity,soft tissue attaching the inner side of the greater trochanter need to be thoroughly removed to make the opener close to it’s base,To ensure an adequate expansion of femoral cavity,the outside surface of the reamer need to be rubbed repeatedly on the inner lateral side of greater trochanter with a firm contact between each other.