Pemberton髋臼成形术治疗儿童发育性髋关节脱位的疗效  

The Effect of Pemberton Acetabuloplasty for Developmental Dysplasia of the Hip in Children

作　　者：陈子秋 CHEN Zi-qiu(Department of Orthopedics,Taihe Hospital of Shiyan (Affiliated Hospital of Hubei University of Medicine),Shiyan 442000,Hubei,China)

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)骨科,十堰442000

出　　处：《中国现代手术学杂志》2018年第6期430-434,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨Pemberton髋臼成形术治疗儿童发育性髋关节脱位(DDH)的疗效。方法回顾2013年9月～2017年2月选择在我院诊治的DDH患儿78例,按手术方法分为实验组与对照组,各39例。实验组行Pemberton髋臼成形术,对照组行闭合复位铝板固定治疗。比较两组疗效、并发症及手术前后髋臼角、前倾角变化情况。结果所有患者均顺利完成手术,术中无严重并发症发生。术后6个月疗效评价:实验组优32例,良6例,中1例,优良率为97. 4%;对照组优21例,良10例,中4例,差4例,优良率为79. 5%;两组优良率比较差异有统计学意义(P <0. 05)。术后6个月实验组发生创伤性关节炎和切口感染各1例,并发症率为5. 1%,对照组发生创伤性关节炎2例,切口感染4例,神经损伤1例,股骨头坏死3例,并发症率为25. 6%;两组并发症率比较,实验组低于对照组,差异有统计学意义(P <0. 05)。术后6个月两组患儿髋臼角、前倾角均较术前1 d缩小,差异均有统计学意义(P <0. 05);组间比较,实验组低于对照组,差异有统计学意义(P <0. 01)。结论相对于传统固定方法,Pemberton髋臼成形术治疗儿童DDH有利于促进髋臼角、前倾角恢复正常,减少术后并发症的发生,提高术后髋关节功能。Objective To explore the efficacy of Pemberton acetabuloplasty in the treatment of developmental dysplasia of the hip( DDH) in children. Methods A retrospective analysis was conducted in 78 children with DDH treated in our hospital from September 2013 to February 2017. According to surgical procedure,they were divided into two groups with 39 cases for each: Pemberton acetabuloplasty was performed in the experimental group and closed reduction and aluminum plate fixation were performed in the control group. Results All patients were completed the operation successfully without serious complication during the operation. The result of 6-month after the operation revealed that excellent in 32 cases,good in 6 cases and fair in 1 case in the experimental group,and excellent in 21,good in 10,fair in 4 and false in 4 in the control group; And statistical difference appeared in the fineness rate between the two groups( 97. 4% vs. 79. 5%,P <0. 05). There was 1 case of traumatic arthritis and 1 case of incision infection in the experimental group,while there were 2 cases of traumatic arthritis,4 cases of incision infection,1 case of nerve injury and 3 case of femoral head necrosis in the control group. The post-operative complication rate of the experimental group was 5. 1%,which is obviously lower than 25. 6% of the control group( P < 0. 05). The acetabular angle and anteversion angle of 6 months after the surgery were improved in both groups than those before the surgery,and which were lower in the experiment group than those in the control group,and all the differences were significant( P < 0. 05). Conclusion Compares with the traditional fixation,Pemberton acetabuloplasty can promote the restore of acetabular angle and anteversion angle to normal,reduce the incidence of post-operative complications and improve the hip joint function for children with DDH.

关 键 词：Pemberton髋臼成形术 发育性髋关节脱位 髋臼角 前倾角 

分 类 号：R726.8[医药卫生—儿科]