成人发育性髋关节发育不良的诊治现状-中国骨与关节杂志.pdfVIP

. 516 . 中国骨与关节杂志 2016 年 7 月第 5 卷第 7 期 Chinese Journal of Bone and Joint, July 2016, Vol 5, No.7 . 综述 Review . 成人发育性髋关节发育不良的诊治现状 程亮亮　赵德伟 DOI: 10.3969/j.issn.2095-252X.2016.07.009　　中图分类号：R681, R687.4 作者单位：116001　大连大学附属中山医院骨科 通信作者：赵德伟，Email: zhaodewei2016@163.com Current concepts in adult patients with developmental dysplasia of the hip: diagnosis and treatment CHENG Liang-liang, ZHAO De-wei. Department of Orthopedics. Affiliated Zhongshan Hospital of Dalian University, Dalian, liaoning, 116001, PRC Corresponding author: ZHAO De-wei, Email: zhaodewei2016@163.com Abstract Developmental dysplasia of the hip ( DDH ) is a spectrum of disorders that results in anatomic 【 】 abnormalities leading to increased contact stress in the joint, eventually, secondary osteoarthritis. Because of altered anatomy of dysplastic hips and younger age, surgery in these patients requires technically demanding procedures. Early diagnosis and appropriate treatment for DDH are of the utmost importance. This article reviews the diagnosis and treatment of adult patients with DDH, and concludes the current views and the associated surgical techniques. Key words Arthroplasty, replacement, hip; Hip joint; Hip dislocation, congenital; Joint prosthesis; 【 】 Acetabulum; Hip dysplasia 【关键词】　关节成形术，置换，髋；髋关节；髋脱位，先天性；人工关节；髋臼；髋发育不良 髋关节发育不良是因为髋臼先天性发育缺陷所导致 响，主要原因为髂腰肌滑过股骨头表面而产生的弹响 [6] 。 长期生物力学异常而逐渐出现的股骨头半脱位或脱位， 当髋关节无明显的半脱位且无继发性骨关节炎表现时，髋 进而出现负重区软骨退变、软骨下骨坏死，最后发展为 关节活动范围往往是正常的 [5] 。年轻患者往往因股骨颈过 严重骨关节炎 [1] 。该疾病的患者往往在新生儿阶段即可出 度前倾，而表现为髋关节内旋活动范围增大，而内旋活动 现髋关节的异常，因此在过去称之为先天性髋关节发育不 减小则常提示可能继发了骨性关节炎。内旋挤压碰撞试验 良 ( congenital dysplasia of the hip，CDH ) [2] ，因为该病的发 ( 屈曲、内收、内旋髋关节 ) 用于检测盂唇损伤或盂唇与 展演变与年龄密切相关，所以近些年更多的学者称其为发