Higuchi Yoshitoshi, Hasegawa Yukiharu, Ishiguro Naoki
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2015 Aug;77(3):455-63.
Total hip arthroplasty (THA) in patients with high hip dislocation is challenging and technically demanding. Nerve injury is a problem associated with leg lengthening after THA. The purpose of this study was to identify the risk factors for sciatic nerve injury after THA in patients with high hip dislocation. Thirty-seven patients (41 THAs) with Crowe type IV hips were consecutively treated. The average leg lengthening (LL) was 3.2 cm. The average Harris hip score was improved from 57.5 points to 83.1 points at the final follow-up. The clinical outcomes after an average 6.4-years follow-up were satisfactory. Sciatic nerve injury was observed in two joints. LL in the two joints (two patients) with sciatic nerve injury was 5.2 cm and 6.7 cm, respectively. Leg lengthening of >5 cm was a risk factor for sciatic nerve injury. Therefore, leg lengthening of >5 cm should be avoided to prevent sciatic nerve injury.
对于髋关节高位脱位患者，全髋关节置换术（THA）具有挑战性且技术要求高。神经损伤是THA术后肢体延长相关的一个问题。本研究的目的是确定髋关节高位脱位患者THA术后坐骨神经损伤的危险因素。连续治疗了37例（41侧THA）Crowe IV型髋关节患者。平均肢体延长（LL）为3.2厘米。末次随访时，Harris髋关节平均评分从57.5分提高到了83.1分。平均6.4年随访后的临床结果令人满意。在两个关节中观察到坐骨神经损伤。发生坐骨神经损伤的两个关节（两名患者）的LL分别为5.2厘米和6.7厘米。肢体延长>5厘米是坐骨神经损伤的一个危险因素。因此，应避免肢体延长>5厘米以预防坐骨神经损伤。
