髋臼周围截骨联合手术治疗大龄儿童发育性髋关节脱位的临床探究.pdf

提 要 目的：探讨髋臼周围截骨联合手术在治疗大龄儿童发育性髋关节脱位上的临床效 果。资料与方法：对我院 2007 年 1 月至 2009 年 6 月对 46 例 55 髋大龄儿童发育性髋 关节脱位患者行手术治疗并辅以术后序贯性功能锻炼。笔者对所有病例进行临床研 究、随访观察，并借助 x 光片及三维 CT 重建技术，对髋臼指数、股骨前倾角大小等 进行研究，分析出术后并发症的具体原因，总结手术经验。术后 1 年，按照 Muller 和 Seddon 评分标准对髋关节功能进行评定。结果：根据评定标准，46 例 55 髋应用 综合术式治疗发育性髋关节脱位患者当中：优 40 髋，良 11 髋，可 3 髋，差 1 髋，优 良率92.7 ％。根据Severin x 线评定标准对髋关节形态作出评价：优 20 髋，良 27 髋， 可 6 髋，差 2 髋，优良率 85．5 ％。结论：髋臼周围截骨联合手术是治疗大龄儿童发 育性髋关节脱位的有效可靠方法，正确的手术联合运用及术前术后处理是治疗成功的 关键，并能有效减少术后并发症。 关键词 大年龄；发育性髋关节脱位；临床研究；髋臼周围截骨 Clinical research on the combined surgical operation with osteotomy around acetabulum treating the older Developmental Dislocation of the Hip Speciality：Orthopaedics of TCM Anthor ：Duan Jiaxiang Tutor：Prof ：Liu Fuqi Abstract Objective: To investigate the joint procedure with osteotomy around acetabulum in the treatment of older children with developmental dislocation of the hip (DDH) on the clinical effect. Clinical data and method: From the January of 2007 to the June of 2009 ， 46 older patients(55 hips)with dislocated hips was treated with operations assisted with continuous function training. By making a clinical research and observation on all cases, we studied the acetabular index, femoral neck anteversion to analyse the causes of complications and obtain experience of success. One year after, they were assessed of the clinical and x-chip performance according to Muller and Seddon clinical classification. Results: The developmental dislocation of hip efficacy criteria in the application of 46 cases of 55 hip joint surgical treatment of developmental dislocation of the hip, after surgical operation treatment the results were as follow：40 hips got excellent results ，