目的 初步评价初次全髋关节置换术中外旋肌群止点重建的作用。方法 2007年1月至2010年6月，采用后外侧切口入路行初次全髋关节置换65例65髋，在股骨大转子钻孔将外旋肌群止点用PDS线水平褥式缝合重建止点。将重建组THA术后脱位率及患肢外旋肌力与同期常规行THA(未行外旋肌群止点重建，对照组)的70例70髋做比较分析。结果 术后2年内，重建组未发生脱位；对照组则有3髋发生脱位，脱位率差异有统计学意义；按有效肌力3级计算，重建组外旋肌力达有效肌力者占86%，对照组仅占67%，两者差异显著。结论 采用后外侧切口进行THA时外旋肌群止点重建能够有效防止术后脱位，改善患肢外旋肌力。%Objective To observe the effect of the reconstruction of external rotation muscles insertion in primary total hip arthroplasty. Methods From January 2007 to June 2010,65 cases(65 hips) of the primary total hip arthroplasty were performed through posterolateral approach and external rotators insertion were reconstructed to the greater trochanter of the femur by horizontal mattress suture . Results All the patients were followed up from 12 months to 18 months with an average of 15 months. No severe complications occur. According to Bourne evaluation system,12 patients got excellent results,3 fair and 1 bad. Conclusion Severe comminution and displacement of the articular surface is the main feature of the pilon fracture with intact fibula. Reconstruct the articular surface 、bone graft and internal fixation are the effective treatment method.
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