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先天性髋关节脱位的髋关节置换课件

先天性髋关节脱位的髋关节置换课件

ID：20718523

大小：4.50 MB

页数：43页

时间：2018-10-15

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1、THAFORDEVELOPMENTALHIPDYSPLASIADanielJ.Berry,MDMayoClinic Rochester,MN,USATHAFORDYSPLASIA ProblemtoOvercomeonAcetabulumProblem:LateralacetabularbonedeficiencyofvaryingseverityTHAFORDYSPLASIA/LOWDDHACETABULARRECONSTRUCTIONTHAFORDYSPLASIA/LOWDDH AcetabularReconstructionGeneralPrinciples:Uncementedsoc

2、ketOptimizecupstabilityonhostboneDon’tletbonedeficiencydictatecuppositionTHAFORDYSPLASIA/LOWDDH AcetabularReconstructionKeyPoint:UsesupplementalscrewsAvoidpressfitfixationalonewithoutscrewsindeficientacetabulumTHAFORDYSPLASIA/LOWDDHAcetabularReconstructionModerateLateralDeficiency:Medializehipcente

3、rtomedialwallAcceptsomelateraluncoverage(~1.5cm ofcup)AcceptslightelevationofhipcenterMarkedLateralDeficiency:Options:MedializethroughmedialwallHighhipcenterLateralbulkautogenousfemoralheadgraftTHAFORDYSPLASIA/LOWDDHAcetabularReconstructionMANAGEMENTOFTHEDYSPLASTICHIP AcetabularReconstructionMypref

4、erence:Medializeto(butnotthrough)medialwallAcceptslightelevationofhipcenterLateralfemheadgraftifneededHighhipcenteronlyinrarecases10yrs,bonerestoredFEMORALHEADAUTOGRAFTSSlightExtrawork,ExtraRiskTheydobankboneforfutureTHAINDEVELOPMENTALDYSPLASIA AcetabularReconstructionHighDislocationFalseAcetabulum

5、NotthickorwideenoughforcupfixationTrueAcetabulumThickerbonePosteriorcolumn:bestboneTHAINDEVELOPMENTALDYSPLASIAAcetabulum:ReconstructatanatomiccenterSmallcup,22mheadNograft(usually)Technicaltips:-opensocketwithburr-reaminreverseTHAFORDYSPLASIA/LOWDDHConclusionsAcetabularreconstructioninhipdysplasia:

6、UncementedcupSupplementalscrewsJudiciousmedializationStructuralgraftonlywhennecessaryTHAFORDEVELOPMENTALHIPDYSPLASIA:THEFEMORALSIDEDanielJ.Berry,MDMayoClinic RochesterMNTHAFORDYSPLASIA ProblemstoOvercomeonFemoralSideProblemstoovercome:Femoralanatomy:AbnormalneckshaftangleandanteversionLeglength:Var

7、iablediscrepancyTHAFORDYSPLASIA ProblemstoOvercomeFemoralDeformity:TheamountoffemoraldeformitydoesnotalwayscorrelatewithlevelofacetabulardysplasiaTHAFORDYSPLASIAFemoralReconstructionFemoralReconstructionopt

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