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华西医学  2015 

内收肌切断术在晚期股骨头坏死合并髋外展受限中的应用

DOI: 10.7507/1002-0179.20150581, PP. 2046-2049

Keywords: 全髋关节置换术,内收肌切断术,关节活动度,疗效

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Abstract:

目的?探究采用单纯全髋关节置换术(THA)和THA+髋内收肌切断术(HAA)两种方案治疗晚期股骨头坏死合并髋外展受限,术后患者外展功能改善的差异,从而指导临床应用。方法?回顾性收集2011年6月-2012年5月期间收治的74例股骨头坏死合并髋外展活动受限患者,其中38例行单纯THA,36例行THA+HAA。统计患者术前、术后1周、术后12个月髋外展活动度、Harris评分。采用SPSS19.0软件对患者术后1周和12个月髋外展活动增加度和髋关节Harris评分的增加值进行统计学分析。结果?两组患者伤口均Ⅰ期愈合,THA+HAA组2例患者术后出现阴囊轻度肿胀,治疗好转后出院。术后1周,THA+HAA组与THA组患者髋关节被动外展角度分别增加(32.1±2.8)、(19.7±3.3)°,髋关节Harris评分分别增加(45.8±2.8)、(40.9±2.3)分;术后12个月,THA+HAA组与THA组的髋关节主动外展角度分别增加(32.2±0.9)、(26.8±2.8)°,髋关节Harris评分分别增加(52.7±7.2)、(49.4±4.4)分;以上组间比较差异均有统计学意义(P<0.05)。结论?对于晚期股骨头坏死合并髋关节内收畸形较为严重的患者,行THA同时切断内收肌群止点能有效改善髋外展功能受限,进而提高患者术后生活质量以及满意度。

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