用双极内假体进行髋关节半成形术以修复股骨颈骨合成失败

O. N. Yamshikov, S. A. Emelyanov, R. V. Chumakov
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摘要

简介上世纪,髋关节置换术被称为矫形外科最成功的手术。通过植入物置换被破坏的关节组织,可以减轻患者的疼痛,恢复运动能力,确保长期改善生活质量,避免残疾。髋关节内固定术适用于髋关节疾病和股骨颈骨折,根据文献报道,约有35%的成年人患有髋关节疾病。本刊物旨在展示一名左髋关节颈部未生长骨折患者在使用螺钉进行金属骨结合的条件下,因金属结构移位和骨折固位不良而接受双极假体髋关节次全置换术的成功经验。描述临床病例并简要分析相关文献。介绍了使用双极假体对左髋关节进行次全髋关节内固定的经验。根据X光检查方法的数据,以及在评估肢体功能和髋关节运动幅度时对治疗效果进行了评估。使用双极假体进行髋关节置换术后,患者的肢体功能和活动能力得到了完全恢复。之所以选择双极假体加髋臼顶成形术,是因为需要恢复患者的关节功能,同时考虑到患者年龄较大,很有可能进行翻修关节成形术。该方法配合使用增量和单个植入物,在减少创伤的同时取得了良好的治疗效果。根据给出的临床案例,可以得出以下结论:股骨颈骨折的术前规划、风险评估和扩大金属结构的范围(包括对骨组织创伤最小的金属结构)都很重要,同时还需要提高患者治疗的连续性和术后计划的个性化。 患者的管理、社交和激活
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hemiartoplasty of the Hip Joint with a Bipolar Endoprosthesis for Fail Osteosynthesis of the Femoral Neck
Introduction. Hip replacement in the last century was called the most successful operation in orthopedics. Replacement of the destroyed joint tissues with an implant allows to relieve a person from pain, restore motor activity and ensure a long-term improvement in the quality of life without disability. Endoprosthetics is indicated both for diseases of the hip joint, which according to the literature are affected by about 35 % of the adult population, and for fractures of the femoral neck. As a rule, the age of patients undergoing endoprosthetics is older than 60 years.The purpose of this publication is to demonstrate the successful experience of subtotal hip replacement with bipolar endoprosthesis in a patient with an ungrown fracture of the neck of the left hip in conditions of metalosteosynthesis with screws with migration of metal structures and violation of fracture consolidation.Materials and methods. Description of a clinical case and a brief analysis of the literature on this topic. The experience of subtotal endoprosthetics of the left hip joint with a bipolar endoprosthesis is presented. The effectiveness of treatment was evaluated based on the data of X-ray examination methods, as well as when assessing the function of the limb and the amplitude of movement in the hip joint.Results. As a result of hip replacement with a bipolar endoprosthesis, complete restoration of limb function and activity of the patient was achieved.Discussion. The choice of a bipolar endoprosthesis with acetabular roof plasty was due to the need to restore joint function and the desire to maintain a greater potential for revision arthroplasty of the patient, which is very likely given the age. Along with the use of augments and individual implants, the method showed a good result of treatment with less trauma.Conclusion. Based on the given clinical example, it can be concluded that both preoperative planning for femoral neck fractures with risk assessment and expanding the range of metal structures, including the least traumatic for bone tissue, is important, as well as the need to improve continuity in the treatment of patients and individualize the postoperative plan. management, socialization and activation of the patient
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