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[髋臼和股骨近端的大规模重建]

[Massive reconstruction of acetabulum and proximal femur].

作者信息

Poitout D G, Tropiano P, Bernat M, Moulene J F

机构信息

Service de Chirurgie Orthopédique et de Traumatologie, C.H.U. Nord, Chemin des Bourrely, F-13915, Marseille Cedex 20, USA.

出版信息

Eur J Orthop Surg Traumatol. 1996 Dec;6(4):271-277. doi: 10.1007/BF03380096. Epub 2017 Mar 10.

Abstract

UNLABELLED

In revision hip surgery, allografts are useful for restoring the bone stock and allow the muscle fixation avoiding the use of massive metallic prothesis.

MATERIAL AND METHODS

We have reviewed 51 hip reconstructions with a follow up of 4 years and half (1982 - 1991). Indications were: - revision arthroplasties with destroyed acetabulum, - bone tumors (mainly chondrosarcoma).

RESULTS

The results are good for pain, articular movement and the consolidation of the allograft host bone junction. Some complications were encountered: - Post-operative death (early or late for tumoral extension) in case of major surgery for tumor (4 cases). - Deep infections (2 cases). - Weakness of the gluteus medius with hip dislocation needing anti-dislocation device. - Aseptic serous fluid leak meaning immunobiologic reaction of bone grafts (3 cases).

DISCUSSION

This surgery has to be compared to massive reconstruction prostheses, arthrodesis with limb shortening, femoral head and neck resection and in some cases inter ilio-abdominal amputation which gives also major post-operative complication.

摘要

未标注

在髋关节翻修手术中,同种异体骨移植对于恢复骨量很有用,并且能实现肌肉固定,从而避免使用大型金属假体。

材料与方法

我们回顾了51例髋关节重建手术,随访时间为四年半(1982年至1991年)。适应症包括: - 髋臼破坏的关节置换翻修术, - 骨肿瘤(主要是软骨肉瘤)。

结果

在疼痛、关节活动以及同种异体骨与宿主骨结合处的愈合方面,结果良好。遇到了一些并发症: - 肿瘤大手术(4例)导致的术后死亡(因肿瘤扩散早晚期均有)。 - 深部感染(2例)。 - 臀中肌无力伴髋关节脱位,需要防脱位装置。 - 无菌性浆液渗漏,意味着骨移植的免疫生物学反应(3例)。

讨论

这种手术必须与大型重建假体、肢体缩短的关节融合术、股骨头和颈切除术以及在某些情况下的髂腹间截肢术进行比较,后者也会导致严重的术后并发症。

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