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[全髋关节置换术中是否应进行转子截骨术?]

[Should trochanteric osteotomy be performed during total hip replacement?].

作者信息

Smiłowicz M, Kowalczewski J

机构信息

Kliniki Chirurgii Ortopedycznej Instytutu Reumatologicznego w Warszawie.

出版信息

Chir Narzadow Ruchu Ortop Pol. 1990;55(4-6):373-80.

PMID:1369847
Abstract

Advantages and disadvantages of trochanteric osteotomy were discussed. 716 total hip arthroplasties were performed in 594 patients. Trochanteric osteotomy was done in 79 hips (11%) of 68 patients: 39 cases of rheumatoid arthritis, 17 cases of ankylosing spondylitis, 9 cases of osteoarthritis and 3 cases of various conditions. In 73 hips the trochanter was reattached by Charnley, Coventry or Amstutz method; in remaining cases an original method was used. 42 hips in 36 patients were followed up. The results were evaluated on the basis of clinical, radiographic assessment and opinion of the patient. Trochanteric non-union was found in 3 hips (7.1%), delayed union in 2 cases (4.7%), the wire loop was broken in 6 hips (14.2%) with no disturbance of trochanteric union. The authors recommend Trochanteric osteotomy only in cases of difficult access to the joint or in order to prevent soft tissue damage in instances of difficult anatomic conditions.

摘要

讨论了转子截骨术的优缺点。对594例患者实施了716例全髋关节置换术。68例患者中的79髋(11%)进行了转子截骨术:类风湿性关节炎39例,强直性脊柱炎17例,骨关节炎9例,其他病症3例。73髋采用Charnley、Coventry或Amstutz方法重新固定转子;其余病例采用原始方法。对36例患者的42髋进行了随访。根据临床、影像学评估及患者意见对结果进行评价。发现3髋(7.1%)出现转子不愈合,2例(4.7%)出现延迟愈合,6髋(14.2%)钢丝环断裂,但未影响转子愈合。作者建议仅在关节显露困难或解剖条件复杂以防止软组织损伤的情况下采用转子截骨术。

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