股骨转子下截骨联合S-ROM假体治疗高脱位髋臼发育不良的近期疗效观察  

Short-term outcomes of Crowe Ⅳ developmental dysplasia treated by subtrochanteric osteotomy and S-ROM prosthesis

作　　者：李宝丰[1] 李凭跃[1] 黄华扬[1] 张涛[1] 郑小飞[1] 张余[1] 夏虹[1] 

机构地区：[1]广州军区广州总医院骨科医院骨病关节科,510010

出　　处：《中华关节外科杂志（电子版）》2015年第2期34-36,共3页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家自然科学基金(81000819)

摘　　要：目的分析股骨转子下截骨联合S-ROM股骨柄假体全髋关节置换术治疗CroweⅣ型髋臼发育不良的近期疗效。方法 2013年1月至2014年3月,应用股骨转子下截骨联合S-ROM假体全髋关节置换术治疗CroweⅣ型髋臼发育不良患者18例23髋,其中5例双侧,13例单侧。通过股区视觉模拟评分（VAS）、髋关节功能Harris评分、截骨及肢体延长长度,X线片评价等方法评估近期疗效。结果 18例患者均获得良好随访,平均随访15个月（6~23个月）,VAS评分术后较术前明显下降（P〈0.05）,Harris评分由术前平均（41.6±9.8）分,改善至术后（88.2±8.3）分（P〈0.05）。术前肢体平均短缩6.7 cm,术中平均截骨2.5 cm,术后延长4.2 cm。术后X线片示臼杯在真臼位置,股骨柄假体位置良好,无明显松动。所有实行股骨转子下截骨的患者术后6个月已骨性愈合。结论采用股骨转子下截骨联合S-ROM股骨柄假体全髋关节置换治疗CroweⅣ型髋臼发育不良是一种良好的手术方式,近期疗效良好。Objective To analyze the short-term outcomes of subtrochanteric osteotomy and SROM femoral stem prosthesis treating Crowe Ⅳ developmental dysplasia. Methods Twenty-three hips in18 patients of Crowe Ⅳ developmental dysplasia were treated by the subtrochanteric osteotomy and S-ROM prosthesis from January 2013 to March 2014,among which five cases were bilateral,and 18 cases were unilateral. Visual analog scale（ VAS） score,Harris score,the lengths of osteotomy and limb lengthening,and X-ray images were used to evaluate the short-term outcomes. Results The 18 patients were followed up for 15 months（ ranged 6 to 23 months） in average. The VAS scores showed significant difference before and after the operation（ P〈0. 05）. The Harris score improved from（ 41. 6 ± 9. 8） points preoperatively to（ 88. 2 ± 8. 3） points postoperatively（ P〈0. 05）. The average lengths of preoperative limb shortening,osteotomy and postoperative limb lengthening were respectively 6. 7 cm,2. 5 cm,and 4. 2 cm. X-ray images showed that the position of the cup was in the true acetabulum,and the femoral stem prosthesis was in good position without loosening. Bone union was observed six months after the subtrochanteric osteotomy. Conclusion It is a good choice for Crowe Ⅳ developmental dysplasia to perform a total hip arthroplasty with subtrochanteric osteotomy and S-ROM prosthesis,and the short-term outcomes are good.

关 键 词：髋骨折 髋假体 髋脱位 先天性 

分 类 号：R687.3[医药卫生—骨科学]