持续被动活动下自体骨膜移植防治髋关节僵硬  

Periosteal autograft under the influence of continuous passive motion for preventing and treating stiffness of the hip

作　　者：许瑞江[1] 赫荣国[1] 卢强[1] 王浩[1] 李浩宇[1] 顾章平[1] 

机构地区：[1]中国人民解放军总医院小儿外科,北京100853

出　　处：《中华小儿外科杂志》2001年第2期110-111,共2页Chinese Journal of Pediatric Surgery

基　　金：军队留学回国人员启动基金资助 (基金编号 1994-15 7)

摘　　要：目的　在持续被动活动条件下 ,自体骨膜移植修复髋臼关节面软骨缺损防治先天性髋脱位术后关节僵硬。方法　 5例 7个髋关节 ,年龄 10～ 14岁。其中先天性髋脱位术后关节僵硬 2个 ,采取髋关节粘连松解 ;先天性髋脱位 5个 ,行切开复位、改良Chiari骨盆截骨。以上 7个髋臼的关节面软骨缺损采用髋臼加深及自体胫骨骨膜移植修复其缺损。术后持续被动活动每天 6h ,连用 6周。结果　经 1～ 4年随诊 ,原来僵硬的 2个髋关节屈髋活动分别为 90°、30°,先天性髋脱位的 5个髋分别为 70°、80°、80°、90°、90° ,X线片显示髋关节间隙 5个清晰 ,2个狭窄。Objective Periosteal autograft for repairing the defect of the acetabular articular cartilage under the influence of continuous passive motion (CPM) was used to prevent and treat stiffness of the hip in the older child with congenital dislocation of the hip (CDH) postoperatively. Methods 5 patients with 7 hips was studied. The age ranged from 10 to 14 year old. In 7 hips, 2 with postoperative stiffness of CDH was treated by hip adherent lysis and 5 with CDH was treated by open reduction, modified Chiari osteotomy. Because of the defect of the acetabular articular cartilage in 7 hips, their acetabula were deepened and followed by free periosteal autografts of the medial aspect of proximal tibia for repairing their defects. CPM was given for an average of 6 hours daily for a total duration of 6 weeks.Results The hip flexion range of motion was 90°and 30° in 2 stiffness of the hip respectively, and 70°, 80°, 80°, 90° and 90° in 5 dislocated hip respectively. X ray showed that the space of the hip was clear in 5 and narrowed in 2 with 1 to 4 year follow up.Conclusions Periosteal autograft under CPM may prevent and treat stiffness of the hip in the older child with CDH postoperatively.

关 键 词：先天性髋脱位 髋关节僵硬 自体骨膜移植 

分 类 号：R726.8[医药卫生—儿科]