【摘要】：背景:髖關(guān)節(jié)脫位是全髖關(guān)節(jié)置換后主要并發(fā)癥之一。后外側(cè)入路是髖關(guān)節(jié)置換的常用手術(shù)入路。后方軟組織是否進行修復(fù),現(xiàn)在學(xué)術(shù)界存在爭議,而對于股方肌的保護,以往文獻未給予充分的關(guān)注。目的:探討在應(yīng)用后外側(cè)入路進行全髖關(guān)節(jié)置換時,修復(fù)后方軟組織、保護股方肌對置換后早期脫位的影響。方法:回顧性分析2013年1月至2015年8月在徐州醫(yī)科大學(xué)附屬醫(yī)院骨科進行的后外側(cè)入路的初次全髖關(guān)節(jié)置換患者326例的資料。根據(jù)術(shù)中情況分為觀察組和對照組,觀察組187例為修復(fù)后方軟組織、保護股方肌組,對照組139例為不修復(fù)后方軟組織,部分切開股方肌組。將置換后3個月發(fā)生的脫位定義為早期脫位。比較兩種方法對置換后早期脫位率的影響。結(jié)果與結(jié)論:觀察組早期脫位1例(1/187,脫位率0.5%),對照組早期脫位5例(5/139,脫位率3.6%)。對照組患者髖關(guān)節(jié)早期脫位率顯著高于觀察組(P0.05)。結(jié)果說明,在后外側(cè)入路進行的初次全髖關(guān)節(jié)置換過程中,采用保護股方肌、修復(fù)后方軟組織較不修復(fù)后方軟組織、部分切開股方肌的方式早期脫位率更低。保護股方肌及修復(fù)后方軟組織對維持髖關(guān)節(jié)軟組織的平衡有一定意義。
[Abstract]:Background: hip dislocation is one of the main complications after total hip replacement. Posterolateral approach is a common surgical approach for hip arthroplasty. Whether the posterior soft tissue should be repaired is controversial in academic circles, but the previous literature has not paid enough attention to the protection of the femoris muscle. Objective: to investigate the effect of repairing the posterior soft tissue and protecting the quadrate femoris muscle on the early dislocation after total hip arthroplasty with posterolateral approach. Methods: the data of 326 patients with primary total hip replacement underwent posterolateral approach from January 2013 to August 2015 in the Department of Orthopaedics of Xuzhou Medical University were retrospectively analyzed. According to the intraoperative conditions, 187 cases were divided into observation group and control group. 187 cases in observation group were treated with repairing posterior soft tissue, while 139 cases in control group were treated with partial incision of quadratus femoris. The dislocation occurring 3 months after replacement is defined as early dislocation. The effects of the two methods on the early dislocation rate after replacement were compared. Results and conclusion: one case of early dislocation was found in the observation group (1 / 187, the dislocation rate was 0.5%), and 5 cases (5 / 139, 3.6%) in the control group. The rate of early dislocation of hip joint in control group was significantly higher than that in observation group (P0.05). The results showed that in the process of primary total hip replacement through the posterolateral approach, the early dislocation rate of partial incision of the quadratus femoris muscle was lower by protecting the quadratus femoris muscle and repairing the posterior soft tissue than that of the posterior soft tissue. The protection of the quadratus femoris and the repair of the posterior soft tissue are of significance in maintaining the balance of the soft tissue of the hip joint.
【作者單位】： 徐州醫(yī)科大學(xué)附屬醫(yī)院骨科;
【基金】：國家自然科學(xué)基金(81401817)~~
【分類號】：R687.4

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