全髋置换术治疗成人髋臼发育不良伴股骨头坏死  

Total Hip Roplacement for Adolescence Dysplasia of Hip with Avascular Necrosis of the Femoral Head

作　　者：张朝春[1] 陈智能[2] 杨连梓[3] 

机构地区：[1]南京军区福州总医院骨科,福建福州350025 [2]福建中医学院骨伤系 [3]福建省第二人民医院骨科

出　　处：《解剖与临床》2005年第2期120-121,共2页Anatomy and Clinics

摘　　要：目的:探讨全髋置换术治疗成人髋臼发育不良伴股骨头缺血坏死的手术方法。方法:15例成人髋臼发育不良伴股骨头坏死病例,采用自体骨植骨造盖、重建髋臼等方法以达和谐臼容关系、平衡负重力线,恢复股骨头前倾角和颈干角纠正股骨头颈畸形。结果:15例均获随访,随访时间9个月至3年4个月,平均2.6年。术后髋关节功能Harris评分平均81.6分。术后下肢短缩0～2.5cm,平均0.8cm。术后X线显示臼容关系良好,植骨块融合。术后2例两侧肢体不等长仍大于2cm,行走时轻微跛行。结论:成人髋臼发育不良伴股骨头坏死全髋置换术,可以采用自体股骨头松质骨植骨造盖、重建髋臼等方法以达到和谐臼容关系、恢复负重力线,改善病人步态等目的,是一种行之有效的治疗方法。Objective:To evaluate the treatment of adolescence dysplasia of hip with avascular necrosis of the femoral head by total hip replacement.Methods:15 patiens with the adolescence dysplasia of hip with avascular necrosis of the femoral head were treated by autogenous bone for building hood and re-establish coxal cavity ment to make coxafossa and caput femoris harmony and keep weight loading line balance.The femoral head anterior tilt and collodiaphyseal angle were restored to correct the femoral head and neck dysmorphosis.Results:All the patiens were followed up for 9～40 months 2.6 years on the average.Postoperative average score of Harris was 81.6.Preoperativ crispation of the lower limbs was 0～2.5cm,0.8cm on the average showed that the relation of coxafossa and caput femoris was good and the bone graft mixed well.postoperative photographs.Among these cases,the inquality of two sides limbs remained to exceed 2cm in 2 cases,and they walked with slight limp.Conclusion:Autogenous bone for building hood and re-establish ment of coxal cavity to make coxafossa and caput femoris harmony and keep weight loading line balance are effective for treatment of adolescence dysplasia of hip with avascular necrosis of the femoral head,which need total hip replacement.

关 键 词：髋臼发育不良 股骨头坏死 全髋置换术 成人 Harris评分 股骨头缺血坏死 股骨头颈畸形 自体骨植骨 髋关节功能 肢体不等长 松质骨植骨 自体股骨头 手术方法 随访时间 下肢短缩 治疗方法 术后 颈干角 前倾角 平均 植骨块 

分 类 号：R687.3[医药卫生—骨科学]