Ⅰlizarov技术治疗晚期先天性髋关节脱位  

Ⅰlizarov technique for treatment of late congenital dislocation of the hip

作　　者：孙贵耀[1] 张雪华[1] 彭爱民 乔晓光[1] 杨永合 樊涛[1] 曹雨[1] 于海峰[1] 

机构地区：[1]北京市朝阳区双桥医院骨科,100100

出　　处：《中国矫形外科杂志》2017年第23期2139-2142,共4页Orthopedic Journal of China

基　　金：北京市朝阳区科计项目(编号:SF1424)

摘　　要：[目的]探讨改良Ⅰlizarov技术结合微创截骨术治疗髋关节脱位的初期疗效。[方法]2014年1月~2015年12月,收治先天性髋关节脱位患者32例,其中男性8例,女性24例,平均年龄14.5岁(9~45岁),双侧1例,单侧31例,共33髋;男8例8髋,女24例25髋。应用改良Ⅰlizarov外固结合微创截骨术进行治疗,术前术后采用Harris评分系统、VAS评分法及SF-36量表评分进行评估疼痛及生活能力的改善情况。[结果]所有患者均获得随访,术后平均随访时间11.8个月(6~18)个月,切口均一期愈合,2例术后针道感染,2例早期出现膝关节活动受限,1例术后截骨端出现位移,经对症处理后疗效满意。所有患者步态明显改善。Harris评分由术前的(40.47±2.14)分增加至和拆除外固定后6个月时的(86.32±1.29)分,差异有统计学意义(P<0.05)。VAS评分由术前的(8.53±0.80)分减少至拆除外固定后6个月时的(2.75±1.16)分,差异有统计学意义(P<0.05)。SF-36评分由术前的(88.69±5.90)分增加至拆架后6个月时的(110.09±5.50),差异有统计学意义(P<0.05)。[结论]改良Ⅰlizarov外固定髋关节重建术治疗延误处理的髋关节脱位可有效缓解髋部疼痛,明显改善生活质量,是延误处理的先天性髋关节脱位患者可选择的治疗方法之一。[Objective] To explore primary outcome of late congenital dislocation of hip treated by modified Ilizarov technique combined with minimally invasive osteotomy. [Methods] From January 2014 to December 2015, 32 patients with late congenital dislocation of hip joint were treated with aforesaid technique, including 8 males and 24 females with average age of 14.5 years ranged from 9 to 45 years. Harris score, VAS and SF-36 preoperatively and 6 months postoperatively were used to assess the patient＇s pain and life skills. [Results] All the patients were followed up for an average of 11.8 months ranged from 6 to 18 months. Primary healing of incision achieved in all the patients. However, pin tract infection occurred in 2 cases, the knee limit- ed motion in 2 patients and displacement of osteotomy sites in 1 patient, all these problems solved satisfactorily after proper treatment. All patients had significant improvement in gait at 6 months after remove of the external frame compared with that before operation. Harris hip score statistically improved from （40.47±2.14） preoperatively to （86.32±1.29） mm at 6 months after remove of the external frame （P〈0.05）, VAS score considerably decreased from （8.53±0.80） to （2.75±1.16） （P〈0.05）, and SF-36 score significantly increased from （88.69±5.90） to （110.09±5.50） （P〈0.05）. [Conclusion] This modified Ilizarov technique combined with minimally invasive osteotomy for treatment of the late congenital dislocation of hip achieves satisfactory clinical outcome in relieving hip pain and improving quality of life, is recommended as one choice of treatment for this clinical dilemma.

关 键 词：晚期先天性髋关节脱位 改良Ilizarov技术 微创截骨 髋关节重建 

分 类 号：R687.4[医药卫生—骨科学]