应用角度钢板治疗发育性髋关节脱位的临床研究  

Clinical research of application of angle plate in the treatment of developmental dysplasia of the hip

作　　者：李欣[1] 刘宏[1] 方科[1] 文捷[1] 何爱咏[2] 

机构地区：[1]湖南省人民医院小儿骨科,湖南长沙410005 [2]中南大学湘雅二医院骨科,湖南长沙4100011

出　　处：《局解手术学杂志》2012年第3期243-245,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨应用角度钢板治疗儿童发育性髋关节脱位(DDH)的临床疗效。方法回顾分析本组48例(52髋)采用角度钢板行开放复位,股骨短缩内翻去旋转截骨术加Salter或Pemberton截骨术式治疗的DDH患儿临床资料。其中男6例,女42例;左侧26例,右侧18例,双侧4例。患儿手术年龄为2～9岁,平均3.5岁。按Tonnis系统分级:Ⅲ度10例,Ⅳ度38例。结果患儿随访1～4年,平均2.4年,股骨颈前倾角术前测量30°～50°,术中皆矫正至20°左右。股骨颈干角术前140°～160°,术后矫正至125°左右。术前髋臼指数35°～55°,术后矫正至18°～35°。术中行短缩截骨长度0.8～3.0 cm,平均2.0 cm。McKay评分,优35例,良13例。结论角度钢板应用于治疗儿童发育性髋关节脱位临床疗效良好,值得推广应用。Objective To investigate the clinical efficacy of angle plate in the treatment of developmental dysplasia of the hip（DDH） in children.Methods The clinical data of 48 patients（52 hips） with DDH aged from 2~9 years old（averaged 3.5 year old） who were treated by open reduction combined with derotational inverted femoral shortening and salter or pemberton pelvic osteotomy with angle plate were retrospectively analyzed.There were 6 males and 42 females.Among the 48 cases,26 cases were involved with the left,18 cases with the right hip,and 4 cases with bilateral hips.According to the Tonnis system,there were 10 cases of grade 3 and 38 cases of grade 4.Results The patients were followed up for 1~4 years with an average of 2.4 years.The femoral neck anteversion was adjusted to about 20° compared with the preoperative measurement（30°~50°）.The femoral neck collodiaphseal angle was adjusted to about 125° compared with the preoperative measurement（140°~160°）.The acetabular index was adjusted to 18°~35°compared with the preoperative measurement（35°~55°）.The extent of femoral shorting was ranged from 0.8~3.0 cm with an average of 2.0 cm.According to the McKay criteria,there were clinical 35 excellent cases and 13 good cases.Conclusion Angle plate is effective in the treatment of DDH and it is worth promoting in clinics.

关 键 词：发育性髋关节脱位 复位 角度钢板 手术治疗 

分 类 号：R682.17[医药卫生—骨科学] R687.4[医药卫生—外科学]