用于髋关节置换翻修的股骨延长截骨术:结果与并发症

Extended femoral osteotomy for revision of hip arthroplasty: results and complications.

作者信息

Mardones Rodrigo, Gonzalez Carlos, Cabanela Miguel E, Trousdale Robert T, Berry Daniel J

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

J Arthroplasty. 2005 Jan;20(1):79-83. doi: 10.1016/j.arth.2004.10.014.

Abstract

Seventy-five revision total hip arthroplasties (73 patients) performed using an extended greater trochanteric osteotomy for exposure and an extensively porous-coated uncemented stem were reviewed after 2 years (range, 1 to 5). The mean osteotomy length was 14 cm (range, 7 to 19 cm) and fixation was with at least 2 cables. One stem was revised at 4 months for stem subsidence and loosening. Of the remaining 74 osteotomies, 73 healed without further procedures. A single nonunion was reoperated at 4 months and healed. Sixty-eight of 73 osteotomies healed with no migration and 5 did with less than 5 mm of proximal migration of the osteotomy fragment. Complications included 3 intraoperative and 1 postoperative osteotomy fragment fractures. Extended trochanteric osteotomy, executed preserving the fragment's vascularity and fixed with rigid fixation, can be performed with a low rate of complications.

摘要

对75例翻修全髋关节置换术(73例患者)进行了回顾性研究,这些手术采用延长大转子截骨术进行显露,并使用广泛多孔涂层的非骨水泥型假体柄,术后随访2年(范围1至5年)。平均截骨长度为14厘米(范围7至19厘米),固定至少使用2根钢缆。1例假体柄在4个月时因下沉和松动而翻修。其余74例截骨术中,73例无需进一步处理即愈合。1例骨不连在4个月时再次手术并愈合。73例截骨术中68例愈合且无移位,5例截骨块近端移位小于5毫米。并发症包括3例术中及1例术后截骨块骨折。延长转子截骨术在保留截骨块血运并采用坚强固定的情况下,并发症发生率较低。

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