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髋臼骨折的全髋关节置换术:“早期应用”

Total hip arthroplasty for acetabular fractures: "Early Application".

作者信息

Salar Necmettin, Bilgen Muhammet Sadık, Bilgen Ömer Faruk, Ermutlu Cenk, Eken Gökay, Durak Kemal

机构信息

Department of Orthopedics and Traumatology, Uludağ University Faculty of Medicine, Bursa-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2017 Jul;23(4):337-342. doi: 10.5505/tjtes.2016.55675.

Abstract

BACKGROUND

The aim of this study was to evaluate the functional and clinical results of early total hip arthroplasty performed to treat acetabulum fracture.

METHODS

Evaluation of 17 patients who were diagnosed with acetabulum fracture and treated with early total hip arthroplasty between January 2008 and October 2013 was performed. In all, 14 patients were male, and 3 were female, with mean age of 52 years (range: 29-80 years). Time elapsed between trauma and operation was mean of 13 days (range: 2-21 days). Observation period was average of 48.2 months (range: 24-70 months). Mean Harris Hip Score was 89.6 (range: 70-100).

RESULTS

In 13 patients, score was good or excellent. Total of 7 of 10 patients had returned to their pre-trauma jobs. Mean length of time for return to work was determined to be 7.2 months (range: 1.5-24 months). Of the total, 9 (52.9%) patients were diagnosed with heterotopic ossification according to Brooker Classification.

CONCLUSION

After acetabulum fracture, early total hip arthroplasty with the correct indications and appropriate patient can result in functional, pain-free hip joint with the advantages of early mobilization, early return to work, and decrease in reoperation risk. Heterotopic ossification prophylaxis should be considered in the presence of 1 or more risk factors, such as a head injury, high-energy trauma, or associated musculoskeletal injuries.

摘要

背景

本研究的目的是评估早期全髋关节置换术治疗髋臼骨折的功能和临床效果。

方法

对2008年1月至2013年10月间诊断为髋臼骨折并接受早期全髋关节置换术的17例患者进行评估。其中男性14例,女性3例,平均年龄52岁(范围:29 - 80岁)。受伤至手术的时间平均为13天(范围:2 - 21天)。观察期平均为48.2个月(范围:24 - 70个月)。平均Harris髋关节评分89.6分(范围:70 - 100分)。

结果

13例患者评分良好或优秀。10例患者中有7例已恢复受伤前的工作。确定平均重返工作岗位的时间为7.2个月(范围:1.5 - 24个月)。根据布鲁克分类,总共9例(52.9%)患者被诊断为异位骨化。

结论

髋臼骨折后,对有正确适应证的合适患者进行早期全髋关节置换术可获得功能良好、无痛的髋关节,具有早期活动、早期重返工作岗位及降低再次手术风险等优点。存在1个或更多危险因素(如头部损伤、高能创伤或相关肌肉骨骼损伤)时,应考虑预防异位骨化。

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