[Possibilities of leg length equalization in total hip replacement].

Wiesław Kaczmarek, Krzysztof Pietrzak, Andrzej Pucher
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Abstract

Leg length discrepancy is a common and not appreciated complication after THR. Unequal leg length may cause earlier implant wear, patient's dissatisfaction, impair patient's function or even some legal consequences for the surgeon. To achieve the final equal leg length after surgery one must comply with some rules: proper patient's examination, informing patient about possible leg length discrepancy, proper length measurement- both clinical and radiological after antero-posterior pelvis x-ray; proper radiological length measurements especially when some hip contractures are observed, appropriate implant selection, proper prosthesis templating. The intraoperative leg length measurement with some surgical or radiological devices is essential for leg equalization. Special operative techniques are necessary for leg lengthening or shortening without hip instability. Final leg length measurement after surgery is necessary to determine a rehabilitation program.

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[全髋关节置换术中腿长平衡的可能性]。
腿长差异是THR术后常见且不被重视的并发症。腿长不等可能导致假体早期磨损,患者不满意,损害患者功能,甚至给外科医生带来一些法律后果。为了在手术后达到最终相等的腿长,必须遵守一些规则:适当的患者检查,告知患者可能的腿长差异,适当的长度测量-骨盆前后x光检查后的临床和放射学测量;适当的放射长度测量,特别是当观察到一些髋关节挛缩时,适当的植入物选择,适当的假体模板。术中用一些外科或放射设备测量腿长对于腿部平衡是必不可少的。特殊的手术技术是必要的腿延长或缩短没有髋关节不稳定。手术后最后的腿长测量是确定康复计划的必要条件。
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