人工全髋关节置换术后脱位原因（学习资料）课件

《人工全髋关节置换术后脱位原因（学习资料）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%）faultypositioningofoneorbothcomponentsimpingementofthefemuronthepelvisorresidualosteophytesimpingemen

2、toftheneckofthefemoralcomponentonthemarginofthesocketinadequatesoft-tissuetensioninsufficientorweakabductormusclesavulsionornonunionofthegreatertrochanternoncomplianceorextremesofpositioningintheperioperativeperiodfactorsAge,height,andweightdonotseemtobecausativefactorsinmanyseries,dislocationoccur

3、redinwomenmoreoftenthaninmen.apreoperativediagnosisofosteonecrosis,proximalfemoralfractureornonunion,orinflammatoryarthritis.Likelycontributingfactorsincludeextensivesoft-tissuerelease,muscularweakness,smallfemoralheadsize(22mm),andtrochantericnonunion.后外侧入路脱位高发的原因atendencytoretrovertthesocketnadeq

4、uateanteriorretractionofthefemur,sotheacetabularpositioningdeviceisforcedposteriorlyduringcomponentinsertionDivisionofalltheshortexternalrotators防止发生脱位的策略fixingthecupintheproperpositionjudgethepositionofthepatient'spelvisinthehorizontalandverticalplaneswomenwithbroadhipsandnarrowshouldersmenwithana

5、rrowpelvisandbroadshoulderstruepositionofthepelvisalwaysmustbetakenintoaccount防止发生脱位的策略Thefemoralcomponentshouldbefixedwiththeneckin5to10degreesofanteversion（15degreesisacceptable）developmentaldysplasiaorjuvenilerheumatoidarthritis,cancauseerrorinjudgingthecorrectposition（anteversion）Retroversionof

6、thefemoralneckmaybeencounteredwithslippedcapitalfemoralepiphysis,oriftheneckisresectedatanexcessivelylowlevel.防止发生脱位的策略Boneorcementprotrudingbeyondtheflatsurfaceofthecupcancauseimpingementandmustberemovedafterthecuphasbeenfixedinplace.ifthegreatertrochanterisenlargedordistorted,someboneoftenmustber

7、emovedfromitsanteriororposteriormargintopreventimpingement.bonyimpingementismuchmorelikelyiffemoraloffsethasnotbeenadequatelyrestored.Theuseofafemoralcomponentwithenhancedoffsetcanbeverybeneficialinthissitu