非骨水泥股骨假体翻修时术中骨折的相关原因分析Analysis of risk factors relative to intraoperative fracture of the femur in revision of hip arthroplasty
窦勇;周一新;褚亚明;柳剑;
摘要(Abstract):
[目的]探讨采用非骨水泥型股骨假体进行髋关节翻修时术中骨折的发生率、发生原因及相关危险因素。[方法]回顾性研究北京积水潭医院矫形骨科2011年1~12月采用非骨水泥型股骨假体进行翻修的72例患者临床资料,其中男33例,女39例;均为单侧病变。患者翻修时的平均年龄61.7岁(32~82岁),距初次关节置换的时间平均为7.2年(1个月~20年)。分析非骨水泥股骨假体进行髋关节翻修时术中骨折的发生率及发生原因,并将未发生骨折的病例作为对照组,分析术中骨折发生的相关危险因素。[结果]72例翻修患者中有17例(23.6%)发生术中骨折。其中大转子劈裂骨折3例(13.3%)、股骨干部皮质穿孔3例(13.3%)、股骨干部螺旋形骨折8例(47.1%)、股骨干骨折合并股骨远端骨折3例(13.3%)。术中骨折最多见于取骨水泥时(41.2%),其次为开髓及扩髓过程中(29.4%)。[结论]采用非骨水泥股骨假体进行翻修时术中骨折的发生率较高。术中骨折的危险因素包括:术前严重的股骨骨缺损、较低的髓腔-皮质指数、术前假体力线不良及未采用大转子延长截骨的骨水泥型假体翻修。对于骨水泥型假体进行翻修时,大粗隆延长截骨可以有效避免术中骨折的发生。
关键词(KeyWords): 髋;非骨水泥;翻修;术中骨折
基金项目(Foundation):
作者(Author): 窦勇;周一新;褚亚明;柳剑;
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参考文献(References):
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