Madan S, Sekhar S, Fiddian N J
The Royal Bournemouth Hospital, Bournemouth, UK.
Ann R Coll Surg Engl. 2002 Nov;84(6):399-403. doi: 10.1308/003588402760978193.
We analysed 68 cases of acetabular augmentation using the Wroblewski wedge for recurrent posterior dislocation of Charnley total hip replacements inserted through a posterior approach. The follow-up was done by postal questionnaire in living patients or by thorough search of case notes in the dead. All hips were followed up either until death or a minimum of 2 years. The average follow-up for the surviving successful group was 35.3 months. Out of 68 hips, 52 (76%) had no further dislocation at a mean follow-up of 35.3 months (range, 24-95 months). An additional 4 hips became stable after one closed reduction for a re-dislocation. After a second augmentation, 5 more hips were stabilised. Wroblewski wedge augmentation is a simple and effective procedure and should be considered before embarking on major revisions in recurrent posterior dislocations in the elderly with no obvious cause for instability.
我们分析了68例采用Wroblewski楔形块进行髋臼扩大术的病例,这些病例均为经后路植入的Charnley全髋关节置换术后复发性后脱位。对在世患者通过邮寄问卷进行随访,对已故患者则通过全面查阅病历进行随访。所有髋关节均随访至死亡或至少2年。存活成功组的平均随访时间为35.3个月。在68例髋关节中,52例(76%)在平均35.3个月(范围24 - 95个月)的随访中未再发生脱位。另有4例髋关节在一次手法复位治疗再脱位后变得稳定。在第二次扩大术后,又有5例髋关节得以稳定。Wroblewski楔形块扩大术是一种简单有效的手术方法,对于无明显不稳定原因的老年复发性后脱位患者,在进行重大翻修手术之前应考虑采用该方法。