X線解剖学的指標と上方進入法の手術手技

抄録

Objective: The superior approach (SA) in hip arthroplasty (HA) is a method to preserve the short rotator muscles and not to dislocate the femoral head. The procedure is sometimes difficult in cases with high greater trochanter and varus deformity of femoral neck. We analyzed radiographic factors influencing operative durations of HA.

Methods: We included 57 HAs using the SA for femoral neck fractures without contralateral hip fractures or postoperative conditions. We divided the surgical procedure into the five phases. We examined the association between the surgical parameters and radiographic index. This included ①the height of the greater trochanter, ②the length between the top of the greater trochanter of the healthy hip and the acetabular edge, ③the healthy femoral offset, and ④the enter edge angle. We examined the association between the surgical parameters and patients characteristic including their height, body weight (BW) and body mass index (BMI).

Results: The mean age was 80±9.5 years. The mean operative time and bleeding quantity were 56±15 minutes and 130±91.7 g, respectively. There were no statistically significant associations between the radiographic index and surgical procedures. Higher BW and BMI increased the total operation time and the head removal duration (P<0.05).

Conclusion: The radiographic index did not influence any phases of the SA, which can be performed in any case.