Moura Diogo Lino, Garruço António
Centro Hospitalar e Universitário de Coimbra, Departamento de Ortopedia, Coimbra, Portugal.
Rev Bras Ortop. 2017 Mar 3;52(2):154-158. doi: 10.1016/j.rboe.2016.09.008. eCollection 2017 Mar-Apr.
To present a retrospective study of 16 patients submitted to hip disarticulation.
During the period of 16 years, 16 patients who underwent hip disarticulation were identified. All of them were studied based on clinical records regarding the gender, age at surgery, disarticulation cause, postoperative complications, mortality rates and functional status after hip disarticulation.
Hip disarticulation was performed electively in most cases and urgently in only three cases. The indications had the following origins: infection ( = 6), tumor ( = 6), trauma ( = 3), and ischemia ( = 2). The mean post-surgery survival was 200.5 days. The survival rates were 6875% after six months, 5625% after one year, and 50% after three years. The mortality rates were higher in disarticulations with traumatic (66.7%) and tumoral (60%) causes. Regarding the eight patients who survived, half of them ambulate with crutches and without prosthesis, 25% walk with limb prosthesis, and 25% are bedridden. Complications and mortality were higher in the cases of urgent surgery, and in those with traumatic and tumoral causes.
Hip disarticulation is a major ablative surgery with obvious implications for limb functionality, as well as high rates of complications and mortality. However, when performed at the correct time and with proper indication, this procedure can be life-saving and can ensure the return to the home environment with a certain degree of quality of life.
对16例行髋关节离断术的患者进行回顾性研究。
在16年期间，确定了16例行髋关节离断术的患者。所有患者均根据临床记录进行研究，内容包括性别、手术年龄、离断原因、术后并发症、死亡率以及髋关节离断术后的功能状态。
大多数情况下髋关节离断术为择期进行，仅3例为急诊手术。手术指征有以下几种原因：感染（n = 6）、肿瘤（n = 6）、创伤（n = 3）和缺血（n = 2）。术后平均生存期为200.5天。6个月后的生存率为68.75%，1年后为56.25%，3年后为50%。创伤性（66.7%）和肿瘤性（60%）离断术的死亡率较高。在8名存活患者中，一半使用拐杖且无假体辅助行走，25%使用肢体假体行走，25%卧床不起。急诊手术以及创伤性和肿瘤性原因导致的手术并发症和死亡率更高。
髋关节离断术是一种大型切除手术，对肢体功能有明显影响，并发症和死亡率也很高。然而，在正确的时间并具备适当指征的情况下进行该手术，可挽救生命，并能确保患者在一定程度的生活质量下回归家庭环境。
