髋臼骨折后创伤性关节炎全髋关节置换疗效研究.doc

《髋臼骨折后创伤性关节炎全髋关节置换疗效研究.doc》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、髋臼骨折后创伤性关节炎全髋关节置换疗效研究作者：潘进社，张英泽，彭阿钦，李亚洲，张奉琪，陈伟，JamesPWaddell【摘要】［目的］比较髋臼骨折经切开复位内固定治疗和保守治疗后发生创伤性关节炎行全髋关节置换术的远期疗效。［方法］30例(32髋)髋臼骨折患者行保守治疗或切开复位内固定术，髋臼骨折后平均间隔7年5个月(5个月～29年)发生创伤性关节炎，对32髋行全髋关节置换术治疗，手术时平均51岁(25～78岁)。应用非骨水泥人工关节29髋，骨水泥型2髋，混合型1髋。术后平均随访8年9个月(4～17年)。［结果］手术组和保守组在骨移植、翻修率、手术时间和异位骨化发生率方面无显著差异

2、(P>0.05)；失血量有统计学差异(P<0.05)，保守组失血量较多。手术组和保守组临床疗效无显著性差异。［结论］髋臼骨折行保守治疗和手术治疗后发生创伤性关节炎需行人工关节置换治疗，两者远期疗效相似，非骨水泥型关节置换疗效较好。【关键词】髋臼骨折；创伤性关节炎；髋关节置换；切开复位内固定；保守治疗Abstract：［Objective］Tostudycurableeffectoftotalhiparthroplasty(THA)inthetreatmentofpost-traumaticarthritisfollowingprevioustreatmentofopen

3、reductionandinternalfixation(ORIF)orconservativetreatmentofacetabularfractures.［Method］Thirtypatients(32hips)whosufferedtraumaticarthritisfollowingconservativeoroperativetreatmentofacetabularfractureswereperformedwithtotalhiparthroplastywithmeanintervalfromfracturetoarthroplasty7.5years(range,

4、5months-29years)andthepatients'meanage51years(range,25～78years).Replacementofuncementedarthroplastywasperformedin29hips,replacementofcementedarthroplastyin2hipsandhybridreplacementin1hip.Themeanfollow-uptimewaseightyearsandninemonths(range,4～17years).［Result］Therewasnostatisticsignificanceinbo

5、negraft,revision,operationtimeandtherateofheterotopicboneformationafterTHAbetweenthecasesofinitialORIFandconservativegroups(P>0.05).Therewasstatisticsignificanceinbloodlosewithmoreloseininitialconservativegroup(P<0.05).Therewasnostatisticsignificanceinclinicaloutcomebetweenthetwogroups.［

6、Conclusion］AfterTHA,thosepatientsinitiallytreatedconservativelyhadsimilarlong-termresultscomparedwiththosetreatedprimarilybyopenreductionandinternalfixationwhosufferedpost-traumaticarthritisafteracetabularfractureandanuncementedarthroplastycouldprovidebetterresults.5Keywords：acetabularfracture

7、;traumaticarthritis;hipreplacement;openreductionandinternalfixation;conservativetreatment△基金项目：河北省出国留学服务中心资助项目（编号：200403）作者简介：潘进社(1956-)，男，主任医师，教授，硕士研究生导师，研究方向：骨盆与髋臼骨折治疗及相关研究。髋臼骨折后髋关节创伤性关节炎发生率为12%～57％［1］;复位不良是创伤性关节炎发生的主要原因［2］。治疗时多采用人工关节