Salter截骨术联合软组织松解治疗儿童期发育性髋关节脱位的效果观察  

Clinical observation of Salter osteotomy combined with soft tissue release on childhood developmental hip dislocation

作　　者：王康 郝建宗[1] 张放[1] 何明哲[1] 崔硬铁[1] WANG Kang;HAO Jian-zong;ZHANG Fang;HE Ming-zhe;CUI Ying-tie(Pediatric Department of Orthopedics,Children's Hospital of Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院骨一科,石家庄050031

出　　处：《中国医学前沿杂志（电子版）》2020年第1期79-82,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2016年河北省医学科学研究重点课题计划(20160422)。

摘　　要：目的观察Salter截骨术联合软组织松解治疗儿童期发育性髋关节脱位(developmental dislocation of hip joint,DDH)的临床效果。方法选取河北省儿童医院2015年5月至2018年5月收治的80例(89髋)DDH患儿为研究对象,按照其治疗术式,将仅接受Salter截骨术治疗的40例(44髋)患儿纳入对照组,将接受Salter截骨术联合软组织松解治疗的40例(45髋)患儿纳入观察组。对比两组患儿术后1年的临床疗效、影像学指标变化和股骨头坏死发生率。结果两组患儿均获得有效随访,随访时间1~4年,中位随访时间为19个月。术后1年,两组患儿骨性髋臼指数、CE角、Reimers指数均显著小于本组术前(均P<0.05),且观察组患儿上述指标均显著小于对照组(均P<0.05)。两组患儿术后Mckay标准、Severin标准临床优良率比较差异均无统计学意义(均P>0.05)。观察组患儿术后1年股骨头坏死发生率显著低于对照组(P<0.05)。结论在Salter截骨基础上联合软组织松解,能够在保证临床疗效的基础上,显著降低DDH患儿骨性髋臼指数,降低术后股骨头坏死发生率。Objective To observe the clinical effect of Salter osteotomy combined with soft tissue release for the developmental dislocation of hip joint(DDH)in childhood.Method A total of 80 children(89 hips)with DDH treated in Children's Hospital of Hebei Province from May 2015 to May 2018 were divided into observation group and control group according to its treatment method,40 children(44 hips)who received only Salter osteotomy were included in the control group,and 40 children(45 hips)who received Salter osteotomy and soft tissue release were included in the observation group.All children were followed up for 1 year,and the clinical efficacy,imaging index changes,and incidence of femoral head necrosis were compared between the two groups.Result The effective follow-up time was 1~4 years,and the median follow-up time was 19 months.The index of acetabulum,CE angle and Reimers in the two groups were significantly less than those before operation(all P<0.05),and those indexes in observation group were significantly less than those in control group(all P<0.05).There were no significant differences in the clinical excellent and good rates of Mckay standard and Severin standard between the two groups(all P>0.05).The incidence of femoral head necrosis in observation group was significantly lower than that of control group(P<0.05).Conclusion Combined with soft tissue release on the basis of Salter osteo tomy,it can significantly reduce the acetabular index and reduce the incidence of postoperative femoral head necrosis on the basis of ensuring clinical efficacy.

关 键 词：SALTER截骨术 软组织松解 儿童 发育性髋关节脱位 

分 类 号：R726.8[医药卫生—儿科]