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首页> 外文期刊>International Journal of Surgery Case Reports >Constrained captive acetabular cup for recurrent dislocation of hemiarthroplasty in elderly: A case series
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Constrained captive acetabular cup for recurrent dislocation of hemiarthroplasty in elderly: A case series

机译:约束性人工髋臼杯治疗老年人半髋置换术后脱位

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Introduction: Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. Presentation of case: A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out. The follow up period was two years and the functional outcomes were assessed using Harris hip scores. Discussion: The management of recurrent dislocations of hemiarthroplasty in elderly patient are very challenging. Even though various treatment options are described most of them are associated with increased morbidity and mortality and prevent these patients from early mobilisation. The use of captive acetabular avoid repeated dislocations, prolonged bed rest, wearing of a brace and all the complications associated with sustained immobilization. The drawbacks of using constrained cups are hip pain, limited hip movements and loosening. Conclusion: We describe a new method of treatment of this difficult condition with a cemented constrained acetabular captive cup and cement to cement revision using a CDH femoral stem. This method prevents further dislocations and will give good functional outcomes thus reducing the high morbidity and mortality.
机译:简介:髋关节置换术是老年人股骨颈囊内骨折的最常见手术之一。半髋关节置换术的脱位是公认的重要并发症。这与相当高的发病率和死亡率有关。治疗选择包括封闭操作,皮肤和骨骼牵引,转换为全髋关节置换,探查和切开复位并将其排除在髋臼之外。病例报告:回顾性分析了10例复发性闭合手法复位手术失败并失败的患者,这些患者均使用水泥固定的髋臼杯进行了翻修,并用Exeter CDH骨干进行了股骨组件的水泥翻修。随访期为两年,并使用Harris髋关节评分评估功能结局。讨论:老年患者半髋置换的经常性脱位的治疗非常困难。即使描述了各种治疗选择,但大多数都与发病率和死亡率增加相关,并阻止了这些患者的早期动员。使用人工髋臼避免重复脱位,长时间卧床休息,佩戴牙套以及与持续固定相关的所有并发症。使用受限杯的缺点是髋部疼痛,髋部运动受限和松弛。结论:我们描述了一种新的治疗此困难状况的方法,即使用水泥约束的髋臼人工乳托和使用CDH股骨柄将水泥固定至水泥翻修。这种方法可防止进一步的脱位,并能提供良好的功能结果,从而降低高发病率和死亡率。

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