成人严重先天性髋脱位的人工全髋关节置换术  

Total hip arthroplasty for severe congenital dislocation of adult hip mellitus

作　　者：赵建宁[1] 郭亭[1] 周利武[1] 吴苏稼[1] 曾晓峰[1] 施鑫[1] 陆维举[1] 

机构地区：[1]南京军区总医院骨科,南京市210002

出　　处：《中国矫形外科杂志》2006年第5期325-327,共3页Orthopedic Journal of China

摘　　要：[目的]探讨成人严重先天性髋关节脱位行人工全髋关节置换术的方法及治疗效果。[方法]13例CroweⅣ级的患者行人工全髋关节置换手术,术前进行骨牵引治疗2周,术中在松解延长的基础上,重建髋关节旋转中心及髋关节外展功能。术后评估肢体延长长度及髋关节功能。[结果]术后平均随访18个月,髋关节Harris评分平均90分,患肢长度平均延长3.1 cm,有1例出现坐骨神经牵拉症状,短期未出现假体失败现象。[结论]通过松解延长、重建关节功能、选择合适的假体,并注重对神经血管的保护,成人严重先天性髋脱位可以通过人工全髋关节置换术获得满意的治疗效果。[ Objective] To discuss the methods and results of total hip arthroplasty for the adult hip of severe congenital dislocation. [ Method] Thirteen patients with unilateral Crowe type-Ⅳ dislocation underwent total hip replacement. All patients were distracted for two weeks preoperatively, and in the operation procedure, the acetabulat rotation center and abductor function were reconstructed on the basis of soft tissue release. The evaluations after surgery included the leg-length and Harris scores. [ Result] According to the follow-up with an average of 18 months, the Harris hip score averaged 90 points. The leg-length extended 3.1 cm on average. One patient appeared sciatic nerve palsy. [ Conclusion ] Total hip arthroplasty could effectively treat server congenital dislocation of adult hip by the methods of tissue release, reconstruction of acetabular, proper selection of prosthetic and protection of nerve.

关 键 词：先天性髋关节脱位 人工假体 重建髋臼 延长 关节置换 

分 类 号：R687.4[医药卫生—骨科学]