Mukka S, Hassany H H, Sayed-Noor A S
Acta Orthop Belg. 2016 Sep;82(3):557-562.
In this study, the restoration of leg length and global femoral offset and positioning of the femoral stem and acetabular cup of hemiartroplasty (HA) and total hip arthroplasty (THA) after femoral neck fracture (FNF) were compared at the postoperative radiographs between 181 hips operated using the direct lateral (DL) approach and 127 hips operated using the posterolateral (PL) approach. Regarding HA, the DL approach was associated with lengthening of the operated leg (5.7 mm vs. 2.1 mm), p = 0.001. The PL approach had more varus stem position (23% vs. 12%, p = 0.03) and the DL approach had more stems with C-position (58% vs. 32%, p = 0.001). Regarding THA, the DL approach showed increased cup anteversion (28° vs. 21°), p = 0.016, and a decrease in FO (-5.9 mm vs. -2.0 mm, p = 0.04). Surgeons caring for FNF patients are to be aware of the differences in geometrical restroration and component positioning -between the two approaches.
在本研究中,对181例采用直接外侧(DL)入路手术的髋关节和127例采用后外侧(PL)入路手术的髋关节在股骨颈骨折(FNF)后行半髋关节置换术(HA)和全髋关节置换术(THA)后的术后X线片上的下肢长度恢复、整体股骨偏移以及股骨柄和髋臼杯的定位情况进行了比较。对于HA,DL入路与患侧下肢延长有关(5.7 mm对2.1 mm),p = 0.001。PL入路的股骨柄内翻位置更多(23%对12%,p = 0.03),而DL入路C位的股骨柄更多(58%对32%,p = 0.001)。对于THA,DL入路显示髋臼杯前倾角增加(28°对21°),p = 0.016,股骨偏移减少(-5.9 mm对-2.0 mm,p = 0.04)。治疗FNF患者的外科医生应了解这两种入路在几何复位和假体定位方面的差异。