螺旋弹力牵引装置治疗先天性髋脱位的长期随访  

A Long-term Follow up of the Congenital HipDislocation Treating by Polyfunctional Reduction Apparatus

作　　者：包勤德[1] 陈彦君 乔栓杰[2] 

机构地区：[1]解放军264医院骨科,山西太原030001 [2]山西政法干部学院医务所

出　　处：《实用骨科杂志》2000年第3期147-150,共4页Journal of Practical Orthopaedics

摘　　要：目的　对采用螺旋弹力牵引装置治疗先天性髋脱位 ,治疗后 10年以上的患者进行随访 ,探讨 X线结果、临床功能与治疗方式之间的关系 ,找出解决不同年龄 ,不同程度患儿的治疗方法及防止并发症出现的具体措施。方法　本组 138例共 15 8髋 ,复位时平均年龄为 2 2月 ,5 9髋单纯应用装置复位固定 ,6 4髋行内收肌、髂腰肌切断后应用装置复位成功 ,35髋采用 Ferguson's术后安装装置。结果　平均随访 10年 6个月 ,随访时平均年龄 11.8岁。根据周永德评定标准 ,评定优良率为 91.1%。股骨头坏死率 5 .7%。结论　螺旋弹力牵引装置的牵引、自动复位功能减少了人为复位的创伤 ,提高了闭合复位的成功率。装置特定的外展角度及固定期间持续对抗髋周挛缩肌群的作用力 ,使头臼间压力减少 ,股骨头坏死率控制在 6 %以下 ,在保证复位稳定的前提下 ,动静结合使关节僵硬并发症降至Objective:From May.1984 to Dec.1989 the congenital hip dislocation had been treated by polyfunctional reduction apparatus and followed up for an average of 10 years.We have found the relationbetween the X-ray change and clinical function,and so we obtained the method of treatment for different age and different type of the hip dislocation. The complications would be resolved.Methods:This paper reportde138 hips dislocated patients(158 hips),the average age was 22 months.59 hips were reduced simply by this apparatus.After tenotomy of adductor and iliopsoas 64 hips were reduced andapplied the reduction apparatus.35 hips were reduced by Fergusons Operation and fixed by reduction apparatus.The patients were thereduction apparatus in frogleg position for 4 months,and changed inmodified Langs position for 2months.Results:The average follow up time was 10 years and 6 months.At the follow up time the average age was 11.8 years old.Severin X-ray shows the excellent and good results were 73.3%,Mckays clinical result was 91.1%,necrosis of the femoral head was 5.7%.Conclusions:The traction and self-reduction of the polyfunctional reduction apparatus decreased the damage of the manual reduction and increased the percentage of reduction. This apparatus is able to abduct the thigh and tract continued the legs and to decrease the compression of the femoral head against the acetabulum.There for the necrosis of the femoral head would be controlled under 6%.During the period of treatment the reduction is steady,the hip joint can move and rest,so the stiffness of the joint never occur.The long-term succssful results prove that this method has a short treatment time,good result,a little pain and less complication.

关 键 词：先天性髋脱位 螺旋弹力牵引装置 

分 类 号：R682.170.5[医药卫生—骨科学]