摘要：探讨全髋关节置换均衡双下肢长度差异的方法及意义。肢体不等长是全髋关节置换术的常见并发症之一，以肢体延长多见。置入假体选择不当和操作者经验技巧是造成肢体不等长的主要原因。肢体不等长近期可造成神经疼痛不适，远期可能因代偿性骨盆倾抖或脊柱侧弯而导致腰背痛、跛行及假体无菌性松动。通过术前X射线片测量评估患者肢体长度差异程度，采用模板测量预测假体型号大小及置入位置，确定股骨颈截骨平面及患肢所需延长的长度，参考术前计划中测量结果，术中通过测试假体试模、平衡软组织张力，比较标记间距离变化等多种手段综合评估，以获得术后双下肢长度均衡。全髋关节置换过程中平衡肢体长度差异有重要意义，术前测量评估，术中反复测量验证，是获得术后双下肢等长的有效途径。
关键词：全髋关节置换；肢体；不等长

张跃国，杨柳，刘传伟.全髋关节置换后的双下肢不等长与假体选择置入位置及软组织张力等因素的关系[J].中国组织工程研究与临床康复，2008，12(17):3305-3308 [www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3305(ps).pdf]

Limb length inequality in total hip arthroplasty: Effect of implant location and soft tissue tension

Abstract:The aim of this study was to explore the method and significance to correct limb length inequality in total hip arthroplasty. Limb length inequality is one of the common complications in total hip arthroplasty, in particular for limb lengthening. Inappropriate implant prosthesis and limited surgical experience are main causes for limb length inequality. Short-term limb length inequality can cause joint or nerve pain, and long-term one can lead to compensatory pelvic incline or scoliolosis, resulting in lumbodorsal pain, lameness or prosthesis sterile loosening. To achieve limb length equality, we should evaluate limb-length discrepancy by preoperative radiography, identify the size and location of prosthesis on the basis of template, confirm femoral neck osteotomized plane and lengthening length of affected limb, test prosthesis template, balance soft tissue tension, and compare the distance changes between markers. Limb length equality is significant in total hip arthroplasty. Preoperative measurements and assessments as well as perioperative measurements and validation are effective to ensure postoperative limb length equality.

Zhang YG, Yang L, Liu CW.Limb length inequality in total hip arthroplasty: Effect of implant location and soft tissue tension. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(17):3305-3308(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3305(ps).pdf]