Steffen Robert T, Fern Darren, Norton Mark, Murray David W, Gill Harinderjit S
OOEC/Nuffield Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, University of Oxford, Botnar 2, Oxford OX3 7LD, UK.
Clin Orthop Relat Res. 2009 Apr;467(4):934-9. doi: 10.1007/s11999-008-0390-5. Epub 2008 Jul 16.
Femoral neck fracture is one of the most common complications of hip resurfacing and considered by some to be related to reduced blood flow as a consequence of the surgical approach. We measured oxygen concentration during hip resurfacing through the trochanteric flip approach (n = 15 patients) and compared this approach with previous data for the posterior and anterolateral approaches. With the trochanteric flip the average femoral oxygenation decreased during the procedure to approximately 50% of that at the start, however it recovered to starting level by the end of the procedure. Preservation of oxygenation with the trochanteric flip was similar to that observed with the anterolateral approach, but with less variation during the procedure. Both of these approaches were superior in terms of oxygenation preservation to the posterior approach which resulted in a dramatic reduction in oxygenation.
股骨颈骨折是髋关节表面置换最常见的并发症之一，一些人认为这与手术入路导致的血流减少有关。我们通过转子翻转入路（15例患者）测量了髋关节表面置换术中的氧浓度，并将该入路与先前关于后侧和前外侧入路的数据进行了比较。采用转子翻转入路时，术中股部平均氧合水平降至开始时的约50%，但在手术结束时恢复到起始水平。转子翻转入路的氧合保留情况与前外侧入路相似，但术中变化较小。就氧合保留而言，这两种入路均优于后侧入路，后侧入路会导致氧合显著降低。
