关节镜辅助治疗幼儿发育性髋关节脱位长期随访报告.docVIP

关节镜辅助治疗幼儿发育性髋关节脱位长期随访报告 徐会法 黄鲁豫 雷伟 沙佳 李超 徐超 严亚波 李天清 张春礼 第四军医大学附属西京医院骨科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探讨髋关节镜辅助治疗小儿发育性髋关节脱位 (developmental dislocation of the hips, DDH) 的临床效果。方法 2005年1月2010年12月采用髋前侧及大粗隆前上入路髋关节镜技术完成16例 (17髋) 关节镜下增生滑膜刮除, 股骨头圆韧带切除, 髋臼底脂肪组织清理, 髋臼横韧带松解, 盂唇成形术, 术毕髋屈曲外展位管型石膏外固定。术后3、6、9、12个月进行随访, 随访12个月时, 如果髋臼角25°二期行髋臼囊外截骨成形、股骨旋转 (内翻、短缩) 截骨等治疗。随访1年后每6个月随访1次, 测量患儿骨盆髋臼角并进行Mckay和Severin评分。结果 平均手术时间30.2 min (2236 min) , 术中出血平均13.8 ml (1025 ml) , 平均住院4.2 d (35 d) 。16例 (17髋) 随访60132个月 (中位数91个月) , 按Mckay标准, 优16髋, 良1髋, 优良率100%, 按Severin标准, Ⅰ级13髋, Ⅱ级2髋, 优良率88.2% (15/17) 。结论 髋关节镜技术可以使髋关节有效复位、刺激髋臼软骨发育, 必要时配合行二期髋臼囊外截骨成形、股骨截骨 (旋转、内翻、短缩) 是治疗年龄18个月DDH的有效方法。盂唇外2/3切开的手术方式, 保留内缘完整, 能有效防止术后再脱位。 关键词： 髋关节镜; 发育性髋关节脱位; 髋臼截骨术; 作者简介：黄鲁豫, E-mail:huangly@fmmu.edu.cn 收稿日期：2016-10-18 基金：国家自然科学基金资助项目 (项目编号 A Long-term Follow-up of Arthroscopic-assisted Surgery for Developmental Dislocation of Hip in Infants Xu Huifa Huang Luyu Lei Wei Department of Orthopedics, Xijing Hospital, Fourth Military Medical University; Abstract： Objective To investigate the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip (DDH) . Methods Arthroscopic-assisted surgeries were performed in 19 infants (21 hips) under the age of 18 months between January 2005 and December 2010. Anterior and antero-superior greater trochanter approaches were used in these operations, during which the synovial membrane was resected, the femoral head ligamentum teres was excised, the pulvinar was removed, the transverse acetabular ligament was released, and the labrum was fixed. Spica cast and abduction splint were applied for3 months postoperatively. The follow-ups were conducted on the 3 rd month, 6 th month, 9 th months and 12 th month postoperatively.During the 12 th month s follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening and derotation) was applied if the a