如何防止髋部神经肌肉病变的髋关节置换术后脱位

发布时间：2019-05-20 19:15

【摘要】：[目的]探讨防止髋部神经肌肉病变的髋关节置换术后脱位的方法。[方法]4例偏瘫侧、1例儿麻后遗症股骨颈GardenⅣ型骨折,1例儿麻股骨粗隆间骨折全髋置换术后脱位,1例股骨近端骨囊肿骨折股骨头置换术后感染脱位,分别行关节置换或翻修,通过大直径股骨头、长股骨柄恢复下肢长度和软组织张力,1例阔筋膜张肌代替臀中肌,复位后drop-kick试验判定软组织张力。[结果]1例1年后摔倒右股骨Vancouver A型骨折、保守治疗;1例术后半个月脱位,闭合复位、右髋人字石膏固定;随访时间24~60个月,所有病例未出现脱位、感染、松动征象。[结论]髋部神经肌肉病变、髋外展无力患者可以行髋关节置换,选择合适假体,强调外展肌功能恢复或重建可以防止脱位发生。
[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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