改良Salter截骨术治疗先天性髋关节脱位的临床疗效分析  

Observation of effects of the modified Salter osteotomy in the treatment of congenital dislocation of hip

作　　者：马业涛[1] 宋世锋[1] 肖海涛[1] 张熙民 曾凡[1] 陈世强[1] 刘福存[1] 徐孟凡 

机构地区：[1]海南省人民医院创伤骨科,海口570311 [2]海南省东方市人民医院骨科,东方市572600

出　　处：《中国矫形外科杂志》2011年第13期1082-1085,共4页Orthopedic Journal of China

摘　　要：[目的]探讨改良Salter手术及改良贝氏石膏治疗先天性髋关节脱位的疗效。[方法]对26例年龄2—6岁的先天性髋关节脱位患儿应用改良Salter截骨手术进行治疗，术后均采用改良贝氏石膏固定，不固定髋关节。采用x线评定标准和Mackay临床评定标准进行评估。[结果]所有病例随访时间2～9年，平均7．2年。疗效优24例，良1例，并发股骨头坏死及髋关节半脱位1例。x线片测量：髋臼指数术前为40．05°±5．6°，术后为13．28°±5．06°；CE角术前为-0．12°±8．01°，术后为40．12°±5．58°；髋臼覆盖股骨头的百分比：术前组为45．05％±14．07％，术后为106．06％±11．55％。上述各项指标经两两配对t检验，P〈0．05，各组差异有极显著性意义，效果满意，优良率达93％。[结论]改良Salter手术对2～6岁的先天性髋关节脱位患儿疗效显著，结合改良贝氏石膏固定，患儿早期活动髋关节，可获得良好的功能。[ Objective] To evaluate the curative effects of modified salter osteotomy and Batchelor plaster on treating congenital dislocation of the hip （CDH） . [ Methods] Twenty -six pediatric patients （26 hips） aged between 2 to 6 years with congenital hip dislocation were treated with a modified salter osteotomy and postoperative Batchelor plaster without fixing hip joint. All cases were assessed clinically with X - rays and MacKay Criteria. [ Results ] All cases were followed up for 2 to 9 years with an average of 7.2 years. Twenty - four hips had got excellent clinical results and one good result. 1 case was complicated by femoral head necrosis and hip joint subluxation. The pre - operative acetabular index were 40. 05°±5.65°and got 13.28°±5.06°in post - operatively. There were the pre - operative CE angle -0. 12°±8.01°and 40. 12 ±5.58° in postoperative group. The percentage of acetabular cover were 45.05%±14. 07 % in the preoperative group and 106. 06%±11.55% in the postoperative two groups. The index was measured and compared with matching t test （ P 〈 0. 05 ） . The results showed highly significant difference among groups. The curative effect was satisfying with excellent to good rate of 93%. [ Conclusion ] The modified Salter osteotomy has a remarkable curative effect in treating congenital dislocation of the hip of 2 to 6 years old. With modified Batchelor plaster, the patients can exercise hip joint in early stage and acquire favourable functions.

关 键 词：改良Salter截骨 矫形 先天髋脱位 髋臼角 

分 类 号：R687.3[医药卫生—骨科学]