联合术式治疗儿童发育性髋关节脱位的临床研究Clinical study of combined surgical treatment of developmental dislocation of hip in children.pdfVIP

提 要 目的：探讨一种联合术式治疗儿童发育性髋关节脱位(DDH)，观察其临床效果， 并对相关问题进行讨论。方法：选择合适病例，行联合术式(髋关节切开复位、转子 下旋转短缩内翻截骨、改良 Pemberton 髋臼成形术)并辅以术后功能锻炼。按周永德、 吉士俊提出的 DDH 疗效评定标准对术后功能、X 光片及三维 CT 表现进行评定。分 析出现术后并发症的原因，总结治疗经验。结果：91 例 115 髋应用联合术式治疗的 DDH 患儿当中，84 髋为优（30-26 分），16 髋为良（25-21 分），13 髋为可(20-16 分) ， 2 髋为差（15-11 分），优良率为 86.95%。结论：联合术式是治疗儿童发育性髋关节 脱位的有效、可靠方法，能彻底松解髋臼内、外病变的软组织，纠正髋臼及股骨畸形， 恢复髋关节正常的解剖结构。正确的手术操作及术后处理是治疗的关键，能有效的减 少术后并发症。 关键词 临床研究；联合术式；发育性髋关节脱位；儿童 Clinical Research For The Combined Arthroplasty Treating Of Developmental Dislocation Of Hip In Children Speciality：Orthopaedics of TCM Author: Ju Feng Tutor: Prof. Li Li Abstract Objective: To explore a united arthroplasty of treating Developmental Dislocation of the Hip(DDH), to observe the clinical effect and to discuss some related problems. Method: We take modified Pemberton arthroplasty treatment combined with Subtrochanteric Rotation Shortening and varus Osteotomy, dissection and diaplasis which is assisted with function training on selected cases. By conducting the clinical research, we analyze the causes of complications and sum up the experience after evaluating postoperative function and imaging manifestations according to standard of perfection put forward by Zhou Yongde and Ji Shijun. Results: Among the 115 hips (91 DDH patients) that received united arthroplasty treatment, there are 84 cases evaluated excellent (scores of 30-26), 16 fine (scores of 25-21), 13 passing (scores of 20-16) and 2 failure (scores of 15-11). The excellent and fine rate is 86.95 ％. Conclusions: The united arthroplasty treatment is an effective and reliable method on treating Developmental Dislocation of the Hip (DDH). It can completely release aceta