ABSTRACT
BACKGROUND:Developmental dislocation of the hip is a type of adult hip dysplasia, including Crowe III and IV type; the type of dislocation of the hip is a severe prognosis. Total hip replacement is clinicaly used for the complex reconstruction of acetabulum. For injured acetabulum, autologous bone graft is effective to reconstruct acetabulum structure, provides good coverage and stability for the acetabulum. Postoperative combination with effective exercise can ensure the recovery of acetabulum function. OBJECTIVE:To analyze the correlation of prosthesis position selection during total hip replacement with clinical short- and middle-term effects of Crowel III and Crowel IV hip dislocation. METHODS:Clinical data of 28 cases of dysplasia and dislocation of the hip joint combined with severe osteoarthritis, who were treated in the Department of Joint Surgery, the Second Affiliated Hospital, Inner Mongolia Medical University from December 2011 to December 2012, were retrospectively analyzed. Al patients received total hip replacement. Implant was biological artificial total hip joint prosthesis. During 2-year folow-up, patients were rechecked by imaging regularly to analyze the imaging changes of acetabulum prosthesis position and bone graft fusion. Harris hip score was used to assess the recovery of hip function. The correlation of prosthesis position and short- and middle-term effects was analyzed. RESULTS AND CONCLUSION: The filing rate of medulary cavity of prosthesis was above 75%. The initial position was fixed and stable. The stability rate of femur-prosthesis interface reached 100%. Compared with pre-replacement, hip function was significantly improved at 6 months post surgery (t=25.55, 9.07;P < 0.05). These results indicate that total hip replacement for Crowel III and Crowel IV hip dislocation can effectively reconstruct the acetabulum, recover hip function, and stabilize prosthesis. Total hip replacement is characterized by good filing rate, high stability of femoral prosthesis interface, and stable initial fixation. The clinical repair effect is strongly associated with the position of the prosthesis.
ABSTRACT
BACKGROUND:Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function. OBJECTIVE:To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures. METHODS:The surgical efficacy of 12 cases of complicated proximal humerus fractures who had al received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation. RESULTS AND CONCLUSION:Al the patients were fol owed up for 18 months in average (6 to 48 months). Based on Neer scoring, excellent was in 10 cases, good in one case, fair in one case. The excellent rate was 92%. During the fol ow-up period, prosthesis location was good and there were no complications, such as periarticular fractures, nerve injury, infection, dislocation or looseness. Attention should be paid for the effective restoration of shoulder cuff and the correct reconstruction of the large and smal nodules in semi-shoulder arthroplasty. Besides, it also should be combined with the early and standard functional exercises. The clinical effect of semi-shoulder arthroplasty is satisfactory and it is an effective way to treat complicated proximal humerus fractures.