Jasty M, Webster W, Harris W
Hip and Implant Unit, Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
Clin Orthop Relat Res. 1996 Dec(333):165-71.
Significant limb length inequality is not an uncommon problem after total hip replacement. Preoperative measurement of limb length inequality, preoperative planning with radiographic templates, and intraoperative correction with measurements of limb lengths before and after the insertion of the trial components using special calipers can reduce the incidence and magnitude of this problem. A review of 85 consecutive patients who had primary total hip arthroplasty in which these techniques were used by a single surgeon, showed that 43 had limb inequality preoperatively ranging from 0.5 to 7.25 cm, but only 14 (16%) had limb length inequality after surgery. Eleven limbs (13%) had been lengthened 0.5 to 1 cm compared with the contralateral limb. Of the 42 patients with equal limb lengths preoperatively, 3 had a lengthened limb postoperatively compared with their contralateral limb. Four patients were using lifts on the same side because the limb was too short, and 2 were using lifts on the other side because the limb was too long. None of the other patients complained about limb length inequality. The techniques described above are helpful in minimizing limb length inequality during total hip replacements.
在全髋关节置换术后，明显的肢体长度不等是一个并不罕见的问题。术前测量肢体长度不等、使用放射学模板进行术前规划以及术中使用特殊卡尺测量试验假体组件插入前后的肢体长度进行矫正，可降低该问题的发生率和严重程度。对85例由同一位外科医生采用这些技术进行初次全髋关节置换术的连续患者进行回顾性研究发现，43例患者术前存在肢体不等长，范围为0.5至7.25厘米，但术后仅有14例（16%）存在肢体长度不等。与对侧肢体相比，11条肢体（13%）被延长了0.5至1厘米。术前肢体长度相等的42例患者中，有3例术后与对侧肢体相比出现肢体延长。4例患者因肢体过短在同侧使用鞋垫，2例患者因肢体过长在对侧使用鞋垫。其他患者均未抱怨肢体长度不等。上述技术有助于在全髋关节置换术中将肢体长度不等降至最低。
