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1、新医大一附院关节外科2014年2月股骨髓腔入口的正确定位Correct position of femoral canal entry hole入口处必须紧贴梨状窝的前方Entry hole should be just anterior piriform fosse股骨假体柄正确的前倾有赖于入口处的正确定位Correct entry hole resulted In correct ante-version of stem 入口太靠前将导致股骨假体柄的后倾Too anterior entry hole resultedIn retro-version of stem梨状隐窝Piriform
2、fosse避免股骨假体柄的内翻位植入Avoid varus placement of the stem股骨髓腔的纵轴紧靠大转子的内侧缘通过Longitudinal axis of Intra-medullary to greater trochanter股骨髓腔入口位置必须尽可能靠外侧Femoral entry hole mustBe lateral enough必须去除部分大转子以获得股骨假体柄的正确力线Part of greater trochanter must be removed to give correct stem alignment大转子去除不充分将阻碍股骨柄把持器的进入并导
3、致内翻Inadequate removal of greaterTrochanter block the stem holderAnd resulted in varus 用锉刀进一步去除大转子Further removal of greaterTrochanter by rasp骨的充分去除将产生良好的力线Good alignment with enoughBone removal Hand reaming never power-ream采用手动扩髓法，禁止电动操作采用手动扩髓以防止过热引起的骨坏死，并可保留骨内膜层的松质骨以利于和骨水泥的相互交错嵌插（骨水泥型假体）。Hand reami
4、ng of femoral canal to prevent heat necrosisof bone,and to retain the endosteal cancellous bone forcement inter-digitation(cementedStem)股骨假体柄植入水平的调节Adjust level of stem insertion慢慢地植入骨水泥假体柄，避免进入过深Insert cemented stem slowlyAnd dont insert too deep通过比较股骨头中心和大转子尖端之间的位置关系来调节假体植入的深度Adjust depth of inser
5、tion by relationshipBetween center of head and tip of greatertrochanter必须探查真髋臼的位置Must detect level of true floor必须研磨至“真髋臼”Reaming must be down to acetabular“true floor”在X片上，“真髋臼”位于泪滴外侧Acetabular“true floor”represented by lateral limb of tear drop in hip X-ray“真髋臼”与试样髋臼之间必须没有空隙No gap should be presented between trial cup and acetabular“true floor”手术前手术后
关节外科初次髋关节置换的基本手术技巧学习2月份
