【摘要】：[目的]探討防止髖部神經(jīng)肌肉病變的髖關節(jié)置換術后脫位的方法。[方法]4例偏癱側、1例兒麻后遺癥股骨頸GardenⅣ型骨折,1例兒麻股骨粗隆間骨折全髖置換術后脫位,1例股骨近端骨囊腫骨折股骨頭置換術后感染脫位,分別行關節(jié)置換或翻修,通過大直徑股骨頭、長股骨柄恢復下肢長度和軟組織張力,1例闊筋膜張肌代替臀中肌,復位后drop-kick試驗判定軟組織張力。[結果]1例1年后摔倒右股骨Vancouver A型骨折、保守治療;1例術后半個月脫位,閉合復位、右髖人字石膏固定;隨訪時間24~60個月,所有病例未出現(xiàn)脫位、感染、松動征象。[結論]髖部神經(jīng)肌肉病變、髖外展無力患者可以行髖關節(jié)置換,選擇合適假體,強調(diào)外展肌功能恢復或重建可以防止脫位發(fā)生。
[Abstract]:[objective] to explore the method of preventing dislocation of hip joint after hip replacement with hip neuromyopathy. [methods] there were 4 cases of hemiplegic side, 1 case of Garden type IV fracture of femoral neck, 1 case of total hip replacement dislocation of intertrochanter fracture and 1 case of infection dislocation after bone fracture of proximal bone cyst of femur. Joint replacement or revision was performed respectively. The length of lower extremity and soft tissue tension were recovered by large diameter femoral head and long thigh handle. One case of extensor fascia lata muscle replaced gluteus medius muscle. Soft tissue tension was determined by drop-kick test after reduction. [results] one case of Vancouver A fracture of right thigh fell one year later, conservative treatment, 1 case of dislocation, closed reduction and right hip herringbone fixation, follow-up time 24 鈮，

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