三维CT辅助下大龄发育性髋关节脱位的个体化手术治疗  

3DCT-aided individualized surgical treatment for developmental dysplasia of hip in older children

作　　者：周强[1] 李颖[1] 蒋继亮[1] 童樑成 

机构地区：[1]解放军第454医院骨科,南京210002

出　　处：《中国矫形外科杂志》2012年第11期1006-1009,共4页Orthopedic Journal of China

摘　　要：[目的]研究三维CT辅助下大龄发育性髋关节脱位的个体化手术治疗临床效果。[方法]对31例年龄7～13岁大龄发育性髋关节脱位患者进行三维CT辅助下个体化手术治疗,根据三维CT测量数据选择具体截骨方式,应用三维CT测定数据及Mackay评定标准进行评定。[结果]随访2～7年,平均5.2年。McKay髋关节评定结果:优15髋(42.9%)、良16髋(45.7%)、差4髋(11.4%),优良率88.6%。无感染或骨不连。术后发生股骨头坏死1例。术前髋臼角为26.1°～40.2°,平均32°;术前髋臼覆盖股骨头百分比-10%～55%,平均-0.5%;术后髋臼角为15.5°～25.0°,平均19.5°;术后髋臼覆盖股骨头百分比98%～112%,平均104%。[结论]三维CT辅助下个体化手术治疗对于大龄DDH的治疗效果满意。[Objective]To investigate the 3DCT-aided individualized surgical treatment for developmental dysplasia of hip（DDH） in older children.[Methods]Thirty-one patients（35 hips） with the age from 7 to 13 years underwent 3DCT-aided individualized surgical treatment.The surgical treatments（osteotomy） were determined by the data meatured by 3DCT.[Results]The patients were followed up for 5.2 years（ranging from 2 to 7 years）.According to the McKay criteria,15 hips got excellent ranking（42.9%）,16 good（45.7%）,and 4 poor（11.4%）,with the fineness ratio at 88.6%）.One case got femoral head ischemia necrosis,and no case got infection or bone nonunion.The average acetabular index were 32°（ranging from 26.1° to 40.2°） preoperatively and 19.5°（ranging from 15.5° to 25°） postoperatively.The mean fraction of coverage of acetabulum was-0.5%（ranging from-10% to 55%） preoperatively and 104%（ranging from 98% to 112%） postoperatively.[Conclusion]The 3DCT-aided individualized surgical treatment has a remarkable curative effect in treating DDH in older children.

关 键 词：三维CT 个体化手术 发育性髋关节脱位 

分 类 号：R687.4[医药卫生—骨科学]