非截骨全髋关节置换术治疗单侧CroweⅣ型髋关节发育不良  

Total hip arthroplasty with no femoral shortening osteotomy for treatment of unilateral Crowe type Ⅳ developmental dysplasia of the hip

作　　者：梅晓亮[1] 张震祥[1] 唐炬[1] 杜雅晴 朱伟[1] MEI Xiao-liang;ZHANG Zhen-xiang;TANG Ju;DU Ya-qing;ZHU Wei(Dept of Orthopaedics,the People′s Hospital of Taizhou City,Taizhou,Jiangsu225300,China)

机构地区：[1]泰州市人民医院骨科,江苏泰州225300

出　　处：《临床骨科杂志》2018年第2期163-166,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81401770)

摘　　要：目的探讨非截骨全髋关节置换术(THA)治疗单侧CroweⅣ型髋关节发育不良(DDH)的临床疗效。方法应用非截骨THA治疗15例单侧CroweⅣ型DDH患者。术中髋臼均置于原真臼位置,通过有限软组织松解,未行股骨短缩截骨。术后对患者满意度、Harris髋关节评分、双下肢不等长等情况进行评估。结果患者均获得随访,时间3~48个月。随访期间无髋关节脱位、假体感染、假体松动发生。Harris髋关节评分由术前25~39(32.8±4.2)分提高至术后85~93(90.3±2.3)分,差异有统计学意义(P<0.05)。末次随访按Harris髋关节评分评估疗效:优12例,良3例。14例患者满意度高。术后随时间延长双下肢相对长度差逐渐缩小,末次随访时双下肢相对长度差为0~10(5.3±3.9)mm。1例有术后坐骨神经牵拉损伤,于术后3个月逐渐恢复。结论非截骨THA治疗单侧CroweⅣ型DDH手术效果满意,该方法相对于转子下截骨可能更简单,远期疗效尚待进一步观察。Objective To investigate the clinical efficacy of total hip arthroplasty(THA)with no femoral shortening osteotomy for unilateral Crowe typeⅣdevelopmental dysplasia of hip(DDH).Methods The 15 patients with Crowe typeⅣDDH in one side underwent THA with no femoral shortening osteotomy.During the operation,the THA were performed with requisite soft tissue release,and all the uncemented cups were inserted at the level of true acetabulum but with no femoral shortening osteotomy.The patients′satisfaction,Harris hip score and bilateral leg-length discrepancy was used to assess the clinical results.Results All patients were followed up for 3~48 months,no prosthesis loosening or infection and dislocation occurred in the follow-up.The Harris hip score was improved from 25~39(32.8±4.2)preoperatively to 85~93(90.3±2.3)postoperatively,it was shown statistically significant difference(P<0.05).The excellent was in 9 cases and good 3 cases according to the Harris hip score at the last follow-up.The satisfaction of 14 patients was high.The leg-length discrepancy of the bilateral sides was corrected gradually,it was 0~10(5.3±3.9)mm at the last follow-up.One case of sciatic nerve injury had occurred and was recovered completely in 3 months postoperation.Conclusions THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral Crowe typeⅣDDH.Compared with subtrochanteric osteotomy,the procedure of no femoral shortening osteotomy is easier technically.However,further follow-up is required to confirm long-term efficacy.

关 键 词：髋关节发育不良 人工全髋关节置换 非短缩截骨 

分 类 号：R687.4[医药卫生—骨科学] R681.1[医药卫生—外科学]