【摘要】 目的探讨全髋关节置换术下肢不等长的重要性及处理.方法选择46例接受单侧全髋关节置换术的患者作为研究对象,男18例,女28例,年龄21-85岁,平均(63±5)岁.通过术前临床检查及骨盆标准正位片测定双下肢不等长的程度,利用模板预测假体置入位置,估计股骨颈截骨平面及股骨距的保留长度.术中根据假体试模反复验证及软组织松解程度有效保持双下肢基本等长.结果术前双下肢等长的16例患者中,术后仅2例患肢延长超过1 cm.术前患肢短缩1.5-5.5 cm的30例患者中,术后仅3例短缩或延长超过1.5 cm.40例患者术后随访6-33个月,平均17.3个月,除2例外均无跛行.结论全髋关节置换术下肢不等长的重要性不容忽视,通过术前测量评估,术中反复测量验证,可有效的保持术后双下肢基本等长,获得满意效果.更多还原

【Abstract】 Objective To explore the importance and management of limb length discrepancy during total hip arthroplasty(THA).Methods 44 patients were chosen to undergo unilateral primary THA between Jan.2001and Dec.2004,including 18 males and 28 females.The mean age of patients was 63.5 years ranging from 21 to 85 years.Evaluation of the limb length discrepancy through clinical measurements and radiographic templates was done preoperatively to predetermine optimal implantation position of the components and to decide the level of the femur neck cut and length of the femur quadrature.The components template was tried repeatedly and the looseness of soft tissue was examined during the operation.All these could maintain equal limb length effectively.Results Of the 16 patients with equal limb length preoperatively,only 2 limb had been lengthened more than 1cm postoperatively.Of the 30 patients with shortened limb from 1.5～5.5cm preoperatively,only 3 had limb length discrepancy more than 1.5cm after surgery.The followed-up periods ranged from 6 to 33 months(mean 17.3 months)in 40 patients.Conclusion The importance of limb length discrepancy during THA must not be neglected.The preoperative measurements and intraoperative leg-length measurement are helpful in minimizing limb length discrepancy during THA and have satisfactory results.更多还原