粗隆下截骨结合Zweymuller假体全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良  

Subtrochanteric shortening osteotomy combining Zweymuller prosthesis in total hip arthroplasty for treatment of Crowe Ⅳ type of developmental dysplasia of hip

作　　者：吴健[1] 王兵[1] 吴玉玲[1] 稽丽丽[1] 姚力[1] 马克勇[1] 

机构地区：[1]连云港市第一人民医院关节外科,222000

出　　处：《中华关节外科杂志（电子版）》2014年第5期39-42,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的：探讨粗隆下短缩截骨结合Zweymuller假体全髋关节置换术（ THA）治疗CroweⅣ型成人发育性髋关节发育不良（ DDH）的早期临床疗效。方法2006年1月至2011年12月对12例（18髋） CroweⅣ型成人DDH患者采用粗隆下短缩截骨结合Zweymuller假体行THA手术。男1例（2髋），女11例（16髋），年龄33～51岁（平均47.7岁）。于术前、术后3、6、12个月，以后每年评估一次。髋关节功能评价采用Harris及Charnely评分，术中记录截骨及患肢延长长度，术后影像学检查对截骨面愈合情况、假体有无松动下沉及髋臼假体稳定性进行评价。结果12例患者均随访到，无死亡，随访时间21～46个月（平均42.3个月），1例发生患肢深静脉血栓；术后末次随访Harris评分（87.50±23.78）分、Charnely评分（17.36±2.01）分均较其术前（37.01±10.42）分（t＝1.82， P＜0.05）、12.00±1.52分（t＝2.83， P＜0.05）明显提高；术中截骨长度平均（2.5±0.98）cm，患肢平均延长（4.24±1.06）cm；术后X线评价无截骨面不愈合及假体下沉及松动，截骨面愈合时间3～11个月（平均4.9个月），术后髋关节旋转中心高度较术前下降45.5 mm，术后髋臼位置良好，髋臼假体覆盖范围93.3％，具有较好初期稳定性；手术治疗优良率88.9％。结论粗隆下短缩截骨结合Zweymuller假体THA术治疗CroweⅣ型成人DDH早期临床随访疗效满意。Objective To evaluate the early efficacy of the subtrochanteric shortening osteotomy combining Zweymuller prosthesis in total hip arthroplasty （ THA ） for the treatment of Crowe Ⅳ type of developmental dysplasia of the hip （DDH）.Methods Twelve patients （18 hips） of CroweⅣDDH were＆amp;nbsp;treated with the subtrochanteric shortening osteotomy combined Zweymuller prosthesis in THA from January 2006 to December 2011.There was one male （two hips） and 11 females （16 hips）, aged from 33 to 51 years （ mean 47.7 years） .The clinical evaluation data were retrospective reviewed before the operation and in the 3rd, 6th, 12th month after the operation, after which the evaluation was performed once a year. Harris hip function and Charnely scores were used to evaluate the hip function.The lengths of the osteotomy and the lengthened limb were recorded during the surgery.The postoperative X-ray images were used to evaluate the healing of the osteotomy surface, the prosthesis loosening and subsidence, as well as the stability of the acetabular prosthesis.Results The 12 patients were followed up, no death cases.The follow-up time was 21-46 months （ mean 42.3 months） .There was one case of the deep vein thrombosis in the involved limb.The postoperative Harris score and Charnely score were significantly higher than those before the operation （87.50 ±23.78 vs.37.01 ±10.42, 17.36 ±2.01 vs.12.00 ±1.52;P＆lt;0.05）.The average osteotomy length was （ 2.5 ±0.98 ） cm, the extended limb length was （ 4.24 ±1.06 ） cm in average.The postoperative X-ray showed no nonunion of the osteotomy surface, nor prothesis subsidence or loosening.the healing time of the osteotomy surface were 3-11 months （ mean 4.9 months）;the height of the hip rotation center decreased 45.5mm after the operation; the postoperative acetabular location was good with an acetabular component coverage of 93.3%, which indicated a good primary stability.The surgical excellent rate was 88.9%.Conclusion The early efficacy of

关 键 词：髋脱位 关节置换 截骨术 

分 类 号：R687.4[医药卫生—骨科学]