Frankel A, Booth R E, Balderston R A, Cohn J, Rothman R H
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Clin Orthop Relat Res. 1993 Mar(288):209-13.
Cemented total hip arthroplasties (THAs) were performed through a Charnley transtrochanteric approach in 1162 patients from 1970 through 1986. Trochanteric separations numbered 58 (5%). Rate of nonunion was related to gender, preoperative diagnosis, and prior THA or endoprosthesis. Nonunion patients had lower mean Charnley pain and function mean scores than union patients at the 45- and 49-month examinations, respectively. A Trendelenberg gait was noted in 17% of nonunions compared with 6% of united patients. Revision rates were nearly three times higher in nonunion patients. These results indicate there is a quantifiable risk for a surgeon who chooses to use a trochanteric osteotomy.
1970年至1986年期间，对1162例患者采用Charnley经转子入路进行了骨水泥型全髋关节置换术（THA）。转子分离病例有58例（5%）。骨不连发生率与性别、术前诊断以及既往全髋关节置换术或内置假体有关。在45个月和49个月检查时，骨不连患者的Charnley疼痛和功能平均评分分别低于骨愈合患者。骨不连患者中有17%出现Trendelenberg步态，而骨愈合患者中这一比例为6%。骨不连患者的翻修率几乎高出三倍。这些结果表明，对于选择采用转子截骨术的外科医生而言，存在可量化的风险。
