| 偏瘫侧股骨颈骨折关节置换手术的研究进展 |
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投稿时间：2019-11-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 闫宇鑫 |
YAN Yu-xin |
山西医科大学, 山西 太原 030001
山西医科大学第二医院, 山西 太原 030001 |
Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 张志强 |
ZHANG Zhi-qiang |
山西医科大学, 山西 太原 030001
山西医科大学第二医院, 山西 太原 030001 |
Shanxi Medical University, Taiyuan 030001, Shanxi, China |
z13393430930@163.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第12期，第1184-1188页 |
| DOI：10.12200/j.issn.1003-0034.2020.12.019 |
| 基金项目: |
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| 中文摘要:随着我国进入老龄化社会，脑血管意外遗留偏瘫的患者也逐渐增多，而这类患者发病后第1年内髋部骨折的风险比普通人高4倍且多发生在偏瘫侧。对于老年性股骨颈骨折，人工关节置换术几乎是首选治疗方案，手术技术成熟且有很好的疗效。目前认为，脑血管意外后遗留偏瘫的患者在发生偏瘫侧股骨颈骨折后，偏瘫侧肌力如能达到Ⅲ级，则可首选髋关节置换手术治疗。但是手术中偏瘫患者的情况较常人不同，其偏瘫侧肢体可能存在肌肉萎缩、肌力失衡、骨质疏松等问题，为手术方案的制定带来了困难。本文主要针对手术入路的选择问题、使用全髋关节置换还是半髋、使用骨水泥型假体还是非骨水泥型假体以及如何降低术后脱位的发生率这几方面进行讨论，其中针对术后脱位的问题又从假体选择、软组织技术、下肢长度及偏心距的恢复以及髋臼杯外展角几方面出发进行了分析，目的是为骨科医生在临床决策中提供更多的参考证据。 |
| 【关键词】偏瘫 股骨颈骨折 关节成形术,置换,髋 |
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| Research progress on joint replacement for hemiplegic femoral neck fracture |
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| ABSTRACT With China's aging society,the number of patients with hemiplegia caused by cerebrovascular accident is increasing gradually. The risk of hip fracture in the first year after the onset of this kind of patients is 4 times higher than that of ordinary people,and most of them occur in the side of hemiplegia. For senile femoral neck fracture,artificial joint replacement is almost the first choice of treatment,with mature operation technology and good curative effect. At present,it is considered that if the muscle strength of hemiplegic side can reach grade III after cerebral vascular accident,hip arthroplasty can be the first choice for hemiplegic patients with hemiplegic femoral neck fracture. However,the situation of hemiplegic patients is different from that of ordinary people. The hemiplegic limbs may have muscle atrophy,muscle strength imbalance,osteoporosis and other problems,which brings difficulties to the formulation of surgical plan. This paper mainly discusses the choice of surgical approach,the use of total hip arthroplasty or hemiarthroplasty,the use of cemented prosthesis or cementless prosthesis,and how to reduce the incidence of postoperative dislocation The purpose is to provide more reference evidence for orthopedic doctors in clinical decision-making. |
| KEY WORDS Hemiplegia Femoral neck fracture Arthroplasty,replacement,hip |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闫宇鑫,张志强.偏瘫侧股骨颈骨折关节置换手术的研究进展[J].中国骨伤,2020,33(12):1184~1188 |
| 英文格式: | YAN Yu-xin,ZHANG Zhi-qiang.Research progress on joint replacement for hemiplegic femoral neck fracture[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(12):1184~1188 |
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