Ⅰ期全髋关节置换治疗髋臼骨折

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1、万方数据·982-生堡剑笾盘壶!鱼塑笙!!旦筮丝鲞筮!!魍垡也』堕坠翌：旦墼!世塑!螋!：!型：丝，№：!圣I期全髋关节置换治疗髋臼骨折王子明孙红振王爱民杜全印吴思宇赵玉峰唐颖I摘要】目的探讨髋臼骨折后I期全髋关节置换(totalhiparthroplasty，THA)的手术适应证和手术方法，观察其临床疗效。方法对ll例髋臼骨折患者行I期THA。其中前柱骨折3例，后壁骨折1例，后柱骨折2例，后柱合并后壁骨折2例，横形骨折l例，横形合并后壁骨折1例，两柱骨折l例。伤后8—37d(平均24d)接受THA。对新鲜髋臼骨折患者，先用重建钢板或螺钉固定骨折以恢复髋臼肇的形态，将切下的股骨头制成颗

2、粒状或块状植于髋臼内后安置臼杯。陈旧性髋臼骨折有节段性髋臼骨缺损者，将切下的股骨头制成大块状进行髋臼内结构性植骨后再安置臼杯。结果术后3个月完全负重，无人工关节脱位。随访时间6—45个月，平均28个月。Harris评分平均78分。髋关节屈伸平均活动度为950。x线片示l例出现髋臼松动及骨溶解征象。结论髋臼骨折移位明显，关节软骨面损伤严重，错过了手术复位时机，可以I期行THA。如能创造稳定的髋臼杯结构，近期临床效果满意。【关键词】髋臼；骨折；关节成形术，置换，髋OnestagetotalhiparthroplastyforacetabularfracturesWANGZi—ming，SU

3、NHong-zhen，WANGAi—min，DUQ妣，l—yin，WUsi—yu，ZHAOYu舌ng，TANGn愕．DepartmentofOrthopedicSurgery，ResearchInstituteofSurgery，DapingHospital，死删MilitaryMedicalUnivers妇，Chongqing400042，ChinaCorrespondingauthor：WANGAi—rain，Tef：0086-23-68757930，Email：trauma2@163．cortt【Abstract】ObjectiveToexploreoperativeindica

4、tions，methodsandeffectofonestagetotalhiparthroplasty(THA)intreatmentofacetabulaxfractures．MethodsOnestagetotalhiparthroplasty(THA)wascarriedoutinllpatientswithacetab,,laxfracturesincluding10malesandonefemale(atmeanageof42．4years)8-37days(mean24days)afterinjury．Therewereanteriorcolumnfracturesint

5、hreepatients，posteriorwallfractureinone，posteriorcolumnfractureintwo，posteriorcolumnfracturecombinedwithposteriorwallfractureintwo，transversefractureinone，transversefracturecombinedwithposteriorwallfractureinoneandtwo—columnfractureinone．Freshacetabularfractureswerefirstfixedwithreconstructionpl

6、ateorscrewstorestoreshapeofacestbularwall；then，granuleorbulkofresectedfemoralheadwereimplantedintoacetabulumposteriortOplacementofacetsbulaxcupprosthesis．Whileforoldacetabularfractures．theresectedfemoralheadwasfirstimplantedonaeetabulaxsuperiorwallandposteriorwallandthenacetabularcupprosthesiswa

7、splaced．ResultsFollow·upfor6-45months(mean28months)showedobdousimprovementofhipjointfunction，withaverageHarris∞oreof78pointsandaverageactivedegreeof950．X—rayfilmpresentedlooseningofacetabulumandosteolysisinonepatient．Allpati