Takigami Iori, Itokazu Mansho, Itoh Yoshiki, Matsumoto Kazu, Yamamoto Takatoshi, Shimizu Katsuji
Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu, Japan 501-1194.
Bull NYU Hosp Jt Dis. 2008;66(2):107-10.
Limb-length inequality is not uncommon after total hip arthroplasty (THA) and may cause subjective problems for patients. During THA a stable reference point must be established to determine changes in leg length. Several methods have been useful in minimizing the incidence and magnitude of this problem. The equalization of leg-length discrepancy during THA can be achieved through the use of a simple measuring device, the calipers dual pin retractor (CDPR).
The CDPR was developed to establish a fixed point on the pelvis that would remain constant throughout the procedure and from which the distance to the greater trochanter could be measured prior to dislocation of the hip. Limb lengths were measured in 56 patients undergoing primary THA, between 2004 and 2006. The CDPR was used in all cases.
The preoperative diagnoses were osteoarthritis in 44 patients, osteonecrosis in five, and rheumatoid arthritis in seven. Average postoperative limb-length inequality was 4.2 mm. None of the patients had to use shoe lifts for equalization of limb lengths or complained of limb-length inequality.
This method of measurement is beneficial with most THA approaches, and the technique is helpful for minimizing limb-length inequality during THA.
全髋关节置换术(THA)后肢体长度不等并不罕见,可能给患者带来主观问题。在全髋关节置换术中,必须建立一个稳定的参考点来确定腿长的变化。有几种方法有助于将这个问题的发生率和严重程度降至最低。通过使用一种简单的测量装置——双针牵开器卡尺(CDPR),可以在全髋关节置换术中实现肢体长度差异的均衡。
开发CDPR的目的是在骨盆上建立一个固定点,该点在整个手术过程中保持不变,并且在髋关节脱位前可从此点测量到大转子的距离。在2004年至2006年期间,对56例行初次全髋关节置换术的患者测量了肢体长度。所有病例均使用了CDPR。
术前诊断为骨关节炎的患者有44例,骨坏死5例,类风湿关节炎7例。术后平均肢体长度不等为4.2毫米。没有患者需要使用鞋垫来均衡肢体长度,也没有患者抱怨肢体长度不等。
这种测量方法对大多数全髋关节置换术入路都有益,并且该技术有助于在全髋关节置换术中将肢体长度不等降至最低。