髋臼成形与股骨截骨联合术治疗儿童发育性髋关节发育不良  

Combining procedure of acetabuloplasty and femoral osteotomy for treatment of children developmental dysplasia of the hip

作　　者：臧俊亭[1] 王宇航[2] 孙博[1] 赵智越 李长胜[1] 

机构地区：[1]吉林大学第一医院骨关节外科,吉林长春130021 [2]吉林大学第一医院日间观察病房,吉林长春130021

出　　处：《中国现代医学杂志》2014年第23期79-83,共5页China Journal of Modern Medicine

摘　　要：目的探讨改良Pemberton髋臼成形术联合股骨转子下旋转短缩截骨术对儿童发育性髋关节发育不良的疗效及并发症。方法采用改良Pemberton髋臼成形术和股骨转子下旋转短缩截骨术治疗了97例（120髋）儿童发育性髋关节发育不良病例。术前采用T觟nnis分级方法对骨盆正位片结果进行分级,术后采用Mckay及Severin标准对术后效果进行评价。结果随访1年~4年2个月,平均2年4个月。Mckay临床疗效评定标准评价：优65髋（54.2%）,良43髋（35.8%）,可12髋（10%）,总体优良率为90%。Severin放射线评价标准：Ⅰ级：69髋（57.5%）;Ⅱ级：30髋（25%）;Ⅲ级：17髋（14.2%）;Ⅳ级：4髋（3.3%）。对T觟nnisⅠ、Ⅱ级与T觟nnisⅢ、Ⅳ级的术后优良率进行对比,发现两者之间差异无统计学意义。结论改良Pemberton髋臼成形术联合股骨转子下旋转短缩截骨术对儿童发育性髋关节脱位起到了良好的治疗效果,术前脱位程度不会对手术效果产生影响。[Objective] To explore the post-operative results and complications of the combining proce- dure of modified Pemberton acetabuloplasty and femoral subtrochantericrotational and shortening osteotomy in treatment of children developmental dysplasia of the hip. [Methods] 97 patients （120 hips） with developmen- tal dysplasia of the hips were operated by the combining procedure of modified Pemberton aeetabuloplasty and femoral subtrochantericrotational and shortening osteotomy. All hips were classified according to T6nnis. At the last followup, patients were all clinically and radiographieally evaluated according to Mckay＇s and Severin＇s criteria. [Results] All patients were followed up 1 year to 4 years and 2 months （averages 2 years and 4 months）. According to Mckay＇s criteria, there were 65 （54.2%） excellent results, 43 （35.8%） good results and 12 （10%） fair results, and the overall rate of excellent and good results was 90%. According to Severin＇s criteria, there were 69 （57.5%） hips were Class Ⅰ, 30 （25%） were Class Ⅱ, 17 （14.2%） were Class Ⅲ, 4 （3.3%） were Class Ⅳ. When we compared the different Tonnis types, no significantly difference in excellent and good results was found. [Conclusion] Satisfactory clinical improvements in the aforementioned parameters can be obtained by the combining procedure. The level of dislocations will not affect the treatment outcomes.

关 键 词：发育性髋关节发育不良 截骨术 治疗结果 

分 类 号：R682.1[医药卫生—骨科学]