保护股方肌及修复后方软组织对后外侧入路全髋关节置换早期脱位的影响

发布时间：2018-09-19 14:15

【摘要】：背景:髋关节脱位是全髋关节置换后主要并发症之一。后外侧入路是髋关节置换的常用手术入路。后方软组织是否进行修复,现在学术界存在争议,而对于股方肌的保护,以往文献未给予充分的关注。目的:探讨在应用后外侧入路进行全髋关节置换时,修复后方软组织、保护股方肌对置换后早期脱位的影响。方法:回顾性分析2013年1月至2015年8月在徐州医科大学附属医院骨科进行的后外侧入路的初次全髋关节置换患者326例的资料。根据术中情况分为观察组和对照组,观察组187例为修复后方软组织、保护股方肌组,对照组139例为不修复后方软组织,部分切开股方肌组。将置换后3个月发生的脱位定义为早期脱位。比较两种方法对置换后早期脱位率的影响。结果与结论:观察组早期脱位1例(1/187,脱位率0.5%),对照组早期脱位5例(5/139,脱位率3.6%)。对照组患者髋关节早期脱位率显著高于观察组(P0.05)。结果说明,在后外侧入路进行的初次全髋关节置换过程中,采用保护股方肌、修复后方软组织较不修复后方软组织、部分切开股方肌的方式早期脱位率更低。保护股方肌及修复后方软组织对维持髋关节软组织的平衡有一定意义。
[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.
【作者单位】：徐州医科大学附属医院骨科;
【基金】：国家自然科学基金(81401817)~~
【分类号】：R687.4

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