髋臼旋转截骨术治疗髋臼发育不良  

Treatment of acetabulum dysplasia by rotation acetabulum osteotomy

作　　者：段以祥[1] 张洪佑[2] 郭传友[1] 于珂[1] 彭国栋[1] 历强[1] 

机构地区：[1]青岛大学医学院附属青岛市市立医院骨科,青岛266011 [2]菏泽市立医院骨科

出　　处：《中国矫形外科杂志》2004年第15期1133-1136,共4页Orthopedic Journal of China

摘　　要：目的 :介绍髋臼旋转截骨术 (RAO)治疗髋臼发育不良 (DDH)的方法及疗效。方法 :对 2 4例 2 8髋DDH施行RAO ,按将CE角矫正至 3 0°的术前设计 ,在距髋臼缘 2 0cm处做穹隆状截骨 ,将髋臼向前外下方旋转 ,交叉克氏针固定。本组中髋关节骨性关节炎 (OAH)前期 4髋 ,早期 15髋 ,进展期 9髋 ,平均CE角 16 4° ,Sharp角 48 6° ,AHI 3 3 8%。结果 :经平均 3年 2个月随访 ,平均疼痛增加 2 3 6分 ,步行能力增加 2 6分 ,关节活动范围增加 0 4分 ,生活工作障碍程度增加 2 4分 ,CE角增加 16 7° ,Sharp角减少 16 6° ,AHI增加 48 8%。原疼痛、跛行症状均缓解 ,恢复正常劳动及工作。共出现并发症 2例 ,大转子固定螺钉松脱 1例 ,轻度臀中肌无力步态 1例。结论 :RAO手术可矫正头臼间异常的匹配关系 ,使头臼间的应力分布均匀 ,避免或延缓OAH的发生和发展 ,对髋关节的骚扰小 ,截骨处易愈合 ,是治疗DDH合并早。Objective:To introduce the method and effect of the treatment of acetabulum dysplasia by rotation acetabulum osteotomy.Method:Twenty-four patients (28 hips) with acetabulum dysplasia were treated by rotation acetabulum osteotomy from April 1995 to June 2001.According to the preoperative design,rectify the CE angle to 30°,after osteotomy were performed archedly 2.0cm from acetabulum brim,rotated the acetabulum anteriorly,laterally and inferiorly,fixed it by crossed Kirschner's wire.In total of 28 hips in 24 patients,there were 4 hips in previous stage,15 hips in early stage and 9 hips in progressive stage,the average CE angle was 16.4°,sharp angle was 48.6° and AHI was 33.8%.Result:The average follow-up time were 3 years 2 months,the average grade increased 23.6 in pain,2.6 in walking ability,0.4 in the range of joint movement,2.4 in the degree of daily life and work disturbance,the CE angle increased 16.7°,the sharp angle decreased 16.6°,AHI increased 48.8%.The fixed screw in great trochanter was loosen and pulled out in 1 case,the mesoglutaeus weak gait appeared in 1 case.Conclusion:Rotation acetabulum osteotomy can correct the abnormal relation between femoral head and acetabulum,avoid or delay the occurrence and progress of hip osteoarthritis,do little damage to hip joint and the bone can be easily healed,so it is an ideal method to treat the acetabulum dysplasia combined with osteoarthritis in early,medium stage.

关 键 词：截骨术 髋臼 发育不良 

分 类 号：R687.3[医药卫生—骨科学]