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ID:19404666
大小:1.69 MB
页数:19页
时间:2018-10-02
《人工全髋关节置换术后脱位原因课件》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、人工全髋关节置换术后脱位发生率Theaverageincidenceofdislocationaftertotalhiparthroplastyisapproximately3%.factorsahistoryofprevioushipsurgeryorrevisiontotalhipreplacement(7.4%)aposteriorsurgicalapproach(5.8%vs2.3%)faultypositioningofoneorbothcomponentsimpingementofthefem
2、uronthepelvisorresidualosteophytesimpingementoftheneckofthefemoralcomponentonthemarginofthesocketinadequatesoft-tissuetensioninsufficientorweakabductormusclesavulsionornonunionofthegreatertrochanternoncomplianceorextremesofpositioningintheperioperativeper
3、iodfactorsAge,height,andweightdonotseemtobecausativefactorsinmanyseries,dislocationoccurredinwomenmoreoftenthaninmen.apreoperativediagnosisofosteonecrosis,proximalfemoralfractureornonunion,orinflammatoryarthritis.Likelycontributingfactorsincludeextensives
4、oft-tissuerelease,muscularweakness,smallfemoralheadsize(22mm),andtrochantericnonunion.后外侧入路脱位高发的原因atendencytoretrovertthesocketnadequateanteriorretractionofthefemur,sotheacetabularpositioningdeviceisforcedposteriorlyduringcomponentinsertionDivisionofallth
5、eshortexternalrotators防止发生脱位的策略fixingthecupintheproperpositionjudgethepositionofthepatient'spelvisinthehorizontalandverticalplaneswomenwithbroadhipsandnarrowshouldersmenwithanarrowpelvisandbroadshoulderstruepositionofthepelvisalwaysmustbetakenintoaccount防
6、止发生脱位的策略Thefemoralcomponentshouldbefixedwiththeneckin5to10degreesofanteversion(15degreesisacceptable)developmentaldysplasiaorjuvenilerheumatoidarthritis,cancauseerrorinjudgingthecorrectposition(anteversion)Retroversionofthefemoralneckmaybeencounteredwiths
7、lippedcapitalfemoralepiphysis,oriftheneckisresectedatanexcessivelylowlevel.防止发生脱位的策略Boneorcementprotrudingbeyondtheflatsurfaceofthecupcancauseimpingementandmustberemovedafterthecuphasbeenfixedinplace.ifthegreatertrochanterisenlargedordistorted,someboneoft
8、enmustberemovedfromitsanteriororposteriormargintopreventimpingement.bonyimpingementismuchmorelikelyiffemoraloffsethasnotbeenadequatelyrestored.Theuseofafemoralcomponentwithenhancedoffsetcanbeverybeneficialinthissitu
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