髋臼转位截骨(TAO)治疗DDH继发早期OA  

Treatment of Developmental Dysplastic Hip with Early Stage of Osteoarthrosis by Transpositional Acetabulum Osteotomy

作　　者：刘朝晖[1] 马渡正明 李子荣[1] 

机构地区：[1]北京中日友好医院,北京100029 [2]日本福冈整形外科病院

出　　处：《实用骨科杂志》2004年第3期210-212,共3页Journal of Practical Orthopaedics

摘　　要：目的　介绍一种治疗髋臼发育不良并早期骨性关节炎的髋臼转位截骨术并评价其结果。方法　 4 3例髋关节发育不良 (DDH)并发骨关节病 (OA) ,全部病人实施了髋臼转位截骨术。结果　术后平均 12个月 (10～ 17个月 )随访 ,术后 Harris评分 93分 (85～ 10 0分 ) ,平均增加 2 5分 ,两者比较有显著性差异 ;术后 CE角 2 0°～ 2 8°,平均 2 4°,两者比较有显著性差异 ;术后髋臼指数 37°～ 4 8°,平均 4 5°,两者比较有显著性差异 ;术后 AHI81% (75 %～ 98% ) ,两者比较有显著性差异。结论　髋臼转位截骨术是治疗髋关节发育不良 ( 型 )并发骨关节病 ( 期 )Objective Introduce the transpositional acetabulum osteotomy,which is an effective method to treat the developmental dyplastic hip with early stage of osteoarthrosis(OA).Methods 43 cases are developmental dysplastic hip(DDH)with OA at stage I.All are symptomatic,the mean Harris score is 68(41～86),the mean lateral central edge(CE)angle is 1.2 degree,the mean Acetabular Index(AHI) is 61 degree.Acetabular-Head index is 51 %.The transpositional acetabulum osteotomy(TAO)was given to all cases.Results All cases were followed up by mean 12 months.Postoperatively,Harris score is 93,CE angle is 24 degree (20～28),AHI is 81 %(75 %～98 %).All above are significant difference from those preoperative.Heteropic ossification occurred in 2 cases with no symptoms;4 cases with bursitis,symptom disappeared after removal of the internal fixation;1 case with nonunion and trendelenburg sign was improved after refixing the greator trochanter;No progress in OA was occurred and no necrosis of acetabulum was appeared.Conclusion Properly operative indications and crucial techniques are the key of good outcome of TAO and TAO is an effectiveness procedure for DDH with OA.

关 键 词：髋臼转位截骨 TAO DDH 早期OA 髋臼发育不良 早期骨性关节炎 手术治疗 

分 类 号：R681.1[医药卫生—骨科学] R684.3[医药卫生—外科学]