摘要
目的:探讨人工全髋关节置换术后肢体不等长的原因,对人工全髋关节置换术前和术中预防措施及术后处理作一综述。资料来源:由第一作者应用计算机检索PubMed数据库(www.ncbi.nlm.nih.gov/pubmed),万方数据库(www.wanfangdata.com.cn)。检索时间:英文文献2001/2008,中文文献2004/2009。检索词:英文检索词为"Leglength discrepancy,hip arthroplasty";中文检索词为"肢体长度,髋关节置换术"。资料选择:计算机初检得到154篇文献,阅读标题和摘要进行初筛,排除因研究目的与此文无关的86篇,内容重复性的研究39篇,保留29篇文献做进一步分析。结局评价指标:人工全髋关节置换后肢体不等长的原因及预防处理措施。结果:人工全髋关节置换术后肢体不等长的主要原因有股骨颈截骨时残端保留过多、使用过长的假体颈、股骨偏心距减小、选择略长的股骨颈假体、髋臼旋转中心下移改变过大等。预防人工全髋关节置换后肢体不等长的有效方法有术前仔细测量评估、数字模板预测指导术中选择假体颈长,术中影像学引导,骨标志间距测量判断肢体长度和综合平衡法等。术后处理:对于肢体长度超过15mm的差异可用鞋跟和楔形的底来调整或反复手法推拿等操作;对于肢体不等长差异超过20mm或伴有并发症的患者可采用翻修手术。结论:肢体不等长是人工全髋关节置换术后常见并发症之一,随着科技的发展,设计个体化的假体及计算机辅助导航关节可能会更大程度地恢复患者的关节功能。.
OBJECTIVE： To explore the reasons for leg length discrepancy following total hip arthroplasty, and to summarize the prevention and treatment of leg length discrepancy after total hip arthroplasty. DATA SOURCES： A computer-based online search was conducted in PubMed （www.ncbi.nlm.nih.gov/pubmed） for the English articles published between 2001 and 2008 with keywords＂Leg length discrepancy, hip arthroplasty＂ and Wanfang database （http：//www.wanfangdata.com.cn） for the Chinese articles published between 2004 and 2009. DATA SELECTION： Totally 154 literatures were retrieved by computer, including 116 English articles and 38 Chinese articles, through reading title and abstract, 112 independent and 51 repeated papers were excluded. The remained 29 literatures were performed further analysis. MAIN OUTCOME MEASURES： Reasons for leg length discrepancy and the prevention and treatment of leg length discrepancy following total hip arthroplasty. RESULTS： The main cause of leg length discrepancy after total hip arthroplasty included redundant neck of femur stump, used longer prothesis neck, diminished femur eccentricity, selected longer neck of femur prothesis, as well as larger movement of cotyloid cavity rotation center. The effective approaches of leg length discrepancy after total hip arthroplasty included careful preoperative planning, intraoperative measurement digital templating and image-guided surgery. It could be the adjusted with heel and shaped bottom for the limbs length which was more than 15 mm after operation, and revision operation maybe applied to patients who had more than 20 mm limbs length or combined with complications. CONCLUSIONS： Leg length discrepancy is one of the common complications following total hip arthroplasty. Along with the development of science and technology, to design individual prothesis and computer-assisted navigation joint can be recover farthest joint function.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第52期10330-10334,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
