| 钽金属垫块重建PaproskyⅢ型重度髋臼骨缺损的近期疗效研究 |
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投稿时间：2015-08-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 唐中尧 |
TANG Zhong-yao |
泸州市中医医院骨伤科, 四川 泸州 646000 |
Department of Orthopaedics, Luzhou Institute of Traditional Chinese, Luzhou, 646000, Sichuan, China |
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| 李鹏 |
LI Peng |
泸州市中医医院骨伤科, 四川 泸州 646000 |
Department of Orthopaedics, Luzhou Institute of Traditional Chinese, Luzhou, 646000, Sichuan, China |
673225427@qq.com |
| 茶晓锋 |
CHA Xiao-feng |
泸州市中医医院骨伤科, 四川 泸州 646000 |
Department of Orthopaedics, Luzhou Institute of Traditional Chinese, Luzhou, 646000, Sichuan, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第12期，第1137-1140页 |
| DOI：10.3969/j.issn.1003-0034.2015.12.017 |
| 基金项目: |
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中文摘要:
目的:探讨钽金属垫块联合多孔钽杯翻修髋臼负重环骨缺损的方法及近期疗效。
方法:自2009年3月至2012年12月分析在全髋关节翻修术中采用钽金属垫块联合多孔钽杯重建PaproskyⅢ型髋臼骨缺损的12例(12髋)患者,其中男5例,女7例;年龄45～78岁,平均64岁;病程3～32个月,平均16个月。按照Paprosky分类标准,均为PaproskyⅢ型髋臼骨缺损。所有患者翻修术中均采用钽金属垫块进行骨缺损的修复,并结合使用大直径的生物型髋臼杯进行翻修。记录患者的手术时间、出血量及术后并发症情况,并采用Harris评分进行疗效评价。
结果:术后11例(11髋)获得随访,时间9～36个月,平均25个月,1例患者因车祸死亡而失访。所有患者手术切口均Ⅰ期愈合,手术时间2～6 h,平均3 h,术中出血量300～1 600 ml,平均900 ml.术后无深静脉血栓形成、假体周围骨折、假体周围感染、坐骨神经损伤等并发症出现。Harris评分由术前(46.25±8.99)分提高至术后的(83.75±6.76)分,与术前比较差异有统计学意义(t=3.14,P=0.00<0.05).本组优7例,良2例,可1例,差1例。
结论:钽金属垫块适合于修复髋臼PaproskyⅢ型骨缺损,可修复各种类型的髋臼环缺损,结合颗粒性植骨填补内壁包容性缺损、嵌压于垫块与金属臼杯之间诱导骨长入,为治疗髋臼PaproskyⅢ型骨缺损提供了一种新的选择。 |
| 【关键词】髋臼 修复外科手术 骨缺损 |
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| Short-term effects on reconstruction of Paprosky typeⅢ severe acetabulum bone defect with tantalum metal block |
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ABSTRACT
Objective:To investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky typeⅢ severe acetabulum bone defect.
Methods:Twelve patients(12 hips) with Paprosky typeⅢsevere acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty,were retrospectively analyzed from March 2009 to December 2012. Among the patients,there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old;the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky,all patients were Paprosky typeⅢ acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty,and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared,Harris score were used to evaluate clinical effects.
Results:Eleven patients (11 hips) were followed up from 9 to 36 months with an average of 25 months,1 case was lost to follow-up for dying in car accident. The incisions were healed at stageⅠ. Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis,periprosthetic femoral fracture and infection,sciatic nerve injury occurred after operation. Harris score were improved from(46.25±8.99) before operation to(83.75±6.76) after operation. There was significant difference in Harris score before and after operation(t=3.14,P=0.00<0.05),and 7 cases got excellent results,2 good and 2 moderate.
Conclusion:Tantalum metal block is suitable for revision of PaproskyⅢ acetabulum bone defect,could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft,induce bone growth pressured between metal block and metal cup,provide a new further choose for the treatment of Paprosky typeⅢ severe acetabulum bone defect. |
| KEY WORDS Acetabulum Reconstructive surgical procedures Bone defect |
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| 中文格式: | 唐中尧,李鹏,茶晓锋.钽金属垫块重建PaproskyⅢ型重度髋臼骨缺损的近期疗效研究[J].中国骨伤,2015,28(12):1137~1140 |
| 英文格式: | TANG Zhong-yao,LI Peng,CHA Xiao-feng.Short-term effects on reconstruction of Paprosky typeⅢ severe acetabulum bone defect with tantalum metal block[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(12):1137~1140 |
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