Goodman S B, Huene D S, Imrie S
Division of Orthopaedic Surgery, Stanford University Medical Center, California.
Contemp Orthop. 1992 Jun;24(6):703-10.
The method and results of preoperative templating for the re-establishment of leg length equality during total hip replacement (THR) are reported. The method is a modification of the technique of Müller and requires an anteroposterior radiograph of the pelvis that includes the proximal third of both femora, appropriate acetabular and femoral templates, and tracing paper. To obtain equalization of leg lengths and tissue tension, a composite drawing is made of the operative plan, with all component sizes and important measurements clearly marked. During THR, the lesser trochanter is identified and the femoral neck is osteotomized after a direct measurement is made. These principles were followed in a prospective, consecutive series of 42 primary THR procedures performed by one surgeon. All the radiographic measurements were performed by a single observer. The leg length discrepancy on the postoperative radiograph averaged 3mm (standard deviation = 3mm, range: -9 to +9mm). The postoperative clinical leg length discrepancy averaged 0mm (range: -10 to +10mm). None of the patients complained of leg length inequality. Preoperative templating allows different alternatives to be traced on paper prior to the actual surgical procedure. This method also helps determine the requirements for special prosthetic implants. Acceptable results for postoperative leg length equality may be reliably achieved using this method.
报告了全髋关节置换术（THR）期间用于重建双下肢长度相等的术前模板制作方法及结果。该方法是对Müller技术的改良，需要一张包括双侧股骨近端三分之一的骨盆前后位X线片、合适的髋臼和股骨模板以及描图纸。为实现双下肢长度和组织张力的均衡，要绘制一份手术计划的复合图，清楚标注所有部件尺寸和重要测量值。在全髋关节置换术中，识别小转子并在直接测量后对股骨颈进行截骨。一位外科医生对42例初次全髋关节置换手术进行了前瞻性连续系列研究，并遵循了这些原则。所有X线测量均由一名观察者完成。术后X线片上的双下肢长度差异平均为3mm（标准差=3mm，范围：-9至+9mm）。术后临床双下肢长度差异平均为0mm（范围：-10至+10mm）。没有患者抱怨双下肢长度不等。术前模板制作可在实际手术前在纸上描绘出不同的方案。该方法还有助于确定特殊假体植入物的需求。使用此方法可可靠地实现术后双下肢长度相等的可接受结果。
