一期复位并截骨术治疗学步期TonnisⅢ～Ⅵ度DDH的早期效果评价  

The early effect of treatment in developmental dysplasia of the hip(TonnisⅢ-Ⅵ):one stage open reduction combined with osteotomy for “walking age” children

作　　者：姜华[1] 吴璇昭[1] 陈刚[1] 童晓波[1] 何坤风 

机构地区：[1]贵阳医学院附属医院小儿外科,贵阳550001

出　　处：《重庆医学》2014年第14期1716-1717,共2页Chongqing medicine

摘　　要：目的探讨一期手术治疗学步期发育性髋关节脱位(DDH)的临床疗效。方法回顾性分析本组16例(16髋)DDH患儿采用开放复位、关节囊紧缩、股骨短缩旋转截骨术加Salter或加Dega截骨术式治疗。使用McKay′s及Severin′s分类进行疗效评价,观察术后1年后出现股骨颈变宽、股骨头骨化核破碎、股骨头坏死的发生情况。结果按McKay′s标准优良率87.5%,按Severin′s优良率81.25%,3例发生股骨头坏死,坏死率18.75%。结论一期复位并截骨术治疗学步期DDH的早期临床疗效满意。Objective To investigate the clinical results in the treatment of developmental dysplasia of the hip （DDH） with one stage open reduction and Salter or Dega osteotomy for “walking age”children .Methods We retrospectively reviewed 16 patients（16 hips）with unilateral hip dislocation who had undergone one‐stage open reduction and Salter or Dega innominate osteotomy in the the“walking age”children .the results were evaluated clinically by McKay′s classification and radiologically by the modified Severin′s classification .Early signs of osteonecrosis were identified by neck widening ,epiphysis fragmentation ,and presence of a metaphyseal growth disturbance line in the first year after the operation .Results After a follow‐up of one year on average ,good clinical and ra‐diographic results were noted in 87 .5% and 81 .25% of the patients ,respectively .Osteonecrosis occurred in 3 hips（18 .75% ） .Con‐clusion One‐stage open reduction and Salter or Dega osteotomy is an effective treatment for developmental dysplasia of the hip in walking age .

关 键 词：截骨术 骨坏死 发育性髋关节脱位 

分 类 号：R726.8[医药卫生—儿科]