牵引下直接前侧入路全髋关节置换的并发症△

Complications of total hip arthroplasty through direct anterior approach under traction for femoral neck fracture in elderly

摘要:

[目的]探讨股骨颈骨折牵引下直接前侧入路（direct anterior approach, DAA）全髋关节置换术（total hip arthroplasty, THA）的并发症发生原因及防治方法。[方法]回顾性分析 2018 年 1 月—2021 年 6 月 358 例牵引下 DAA-THA 治疗老年股骨颈骨折患者临床资料。总结并记录发生原因。[结果]358 例患者中 63 例发生并发症，总发生率为 17.6%。并发症发生率由高至低依次为：股外侧皮神经损伤 （8.1%） ＞双下肢不等长 （3.4%） ＞切口渗液 （2.8%） ＞踝关节疼痛 （1.7%） 以及假体周围骨折 （1.7%）。[结论]股骨颈骨折牵引下 DAA-THA 存在双下肢不等长、切口渗液、踝关节疼痛、假体周围骨折、股外侧皮神经损伤等并发症。充分掌握患者病情，提高手术技术和重视术后康复可减少并发症的发生。

Abstract:

[Objective] To explore the cause and prevention of complications of total hip arthroplasty (THA) through the direct anterior approach (DAA) under traction for femoral neck fracture in elderly. [Methods] A retrospective study was conducted on 358 elderly patients who received DAA-THA under traction from January 2018 to June 2021. The complications were summarized and their causes were ana- lyzed. [Results] Complications occurred in 63 cases of the 358 patients, with a total incidence of 17.6%. The incidence of complications in descending order was: lateral femoral cutaneous nerve injury (8.1%) ＞ leg length discrepancy (LLD) (3.4%) ＞ incision effusion (2.8%) ＞ an- kle pain (1.7%) and periprosthetic fracture (1.7%). [Conclusion] DAA-THA under traction for femoral neck fracture does has some compli- cations, such as LLD, incision effusion, ankle pain, periprosthetic fracture and femoral lateral cutaneous nerve injury. Fully grasping the pa- tient's condition, improving the surgical technique and paying attention to postoperative rehabilitation might reduce the occurrence of com- plications.