髋臼造顶术治疗159例先天性髋关节脱位回顾性分析  

A Retrospective Analysis of Shelf Procedure to Treat 159 Cases of Congenital Dislocation of Hip

作　　者：马承宣[1] 赫荣国[1] 刘贵麟[1] 房伦光[1] 王雅芹[1] 许瑞江[1] 李浩宇[1] 王浩[1] 

机构地区：[1]中国人民解放军总医院小儿外科

出　　处：《中华小儿外科杂志》1998年第2期99-101,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的：评价先天性髋关节脱位髋臼造顶术的疗效。方法：为１５９例（２０４髋）先天性髋关节脱位的患儿进行了髋关节切开复位、股骨上端短缩截骨、髋臼造顶术。患儿年龄１．５～１３岁，平均７．５岁。结果：随访３年５０例（６６髋），随访１０年以上２９例（３７髋）。按Ｍｃｋａｙ临床评定标准，３年随访组优良率为８７．８％，随访１０年组为８５．０％。按Ｓｅｖｅｒｉｎ的Ｘ线评定标准，随访３年及１０年组均为７３．０％。结论：通过临床、Ｘ线资料观察发现先天性髋关节脱位的诸多病理改变中，髋臼顶部（也称上部）由正常弧形改变为斜坡尤为重要，髋臼上部弧形截骨加髋臼造顶的联合手术，可使复位后的髋关节更加稳定。Objective: To evaluate the results of a combined shelf procedure in the treatment for congenital dislocation of hip (CDH). Methods: During the last 20 years, 159 cases (204 hips, mean 7.5years of age) were performed open reduction on the femeral head, shortening osteotomy on proximal femur and shelf procedure on acetabulum. Results: Fifty cases (66 hips) were followedup for more than 3 years and 29 cases (37 hips) for 10 years with excellent or good results in 87.8% and 85.0% by Mckay criteria respectively, and only 73.0% by Severin's radiographic criteria. Conclusions: The Xray and clinical findings demonstrate that defect of the upper rim of the acetabulum (vertical roof) should be the main factor of dislocation. The combined arch osteotomy on the upper half of the acetabulum with shelf procedure is beneficial to a stable reduction of CDH.

关 键 词：髋臼造顶术 先天性髋脱位 儿童 

分 类 号：R726.821.7[医药卫生—儿科]