单纯Salter骨盆截骨术与联合股骨近端旋转截骨术在儿童发育性双侧髋关节脱位中的应用  

Application of Proximal Femoral Rotation Osteotomy in DDH

作　　者：徐涛涛 康晓鹏[1] 胡熙[1] XU Taotao;KANG Xiaopeng;HU Xi(Department of Orthopaedics,Kunming Children’s Hospital,Kunming 650100,China)

机构地区：[1]昆明市儿童医院骨科,昆明650100

出　　处：《中国中医骨伤科杂志》2020年第5期23-27,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨股骨近端旋转截骨术在儿童发育性双侧髋关节脱位(DDH)中的应用效果。方法:回顾性分析2014年3月至2019年3月就诊的60例DDH患儿的病例资料,并根据治疗方案的不同分为观察组(29例)和对照组(31例),其中31例对照组患儿行单纯Salter骨盆截骨术治疗,治疗效果欠佳的29例患儿作为观察组,在对照组的基础上联合实施股骨近端旋转截骨术治疗。统计两组患儿的治疗总有效率,测量两组患儿手术前后的骨性髋臼指数(AI)、中心边缘角(CE)和股骨颈前倾角(FNA),根据Harris髋关节功能评分量表(Harris)以及简式Fugl-Meyer运动功能评分法(FMA)测评两组患儿手术前后的髋关节功能以及下肢运动功能,手术后6个月复查时根据步态分析法比较两组患儿的步长、步宽、步速以及并发症总发生率。结果:观察组和对照组的治疗总有效率分别为89.66%和80.65%,差异无统计学意义(P>0.05);观察组经过手术后,AI水平低于对照组,CE和FNA水平高于对照组,差异有统计学意义(P<0.05);观察组经过手术后,Harris和FMA评分高于对照组,差异有统计学意义(P<0.05);观察组手术6个月后复查时,步长和步速指标均高于对照组,差异有统计学意义(P<0.05);观察组和对照组的并发症发生率分别为6.90%和16.13%,差异无统计学意义(P>0.05)。结论:DDH行单纯Salter骨盆截骨术与联合股骨近端旋转截骨术治疗能显著改善患儿髋关节功能和下肢运动功能,预后较好。Objective:To explore the efficacy application of proximal femoral rotation osteotomy on children with developmental dysplasia of the hip(DDH).Methods:A retrospective analysis was performed for 60 DDH children who were treated in Kunming Children’s Hospital from March 2014 to March 2019.They were divided into observation group(29 cases)and control group(31 cases)according to different treatment method.The control group underwent Salter pelvic osteotomy,while the 29 cases with poor curative effect in observation group underwent proximal femoral rotation osteotomy on basis of the method in control group.The total effective rate,acetabular index(AI),center-edge angle(CE),femoral neck anreversion(FNA),Harris hip function scoring scale(Harris),Fugl-Meyer Assessment Scale(FMA),hip function and lower limb motor function in both groups were measured.Overall incidence of complications and stride length,stride width,pace were compared between the two groups by gait analysis method and 6 months after surgery.Results:The total effective rates of treatment in observation group and control group were 89.66%and 80.65%(P>0.05).AI level in observation group was lower than that in control group,and CE and FNA levels were higher than those in control group(P<0.05).Harris and FMA scores in observation group were higher than those in control group(P<0.05).Stride length and pace in observation group were higher than those in control group 6 months after surgery(P<0.05).The incidence rates of complications in observation group and control group were 6.90%and 16.13%(P>0.05).Conclusion:The application of proximal femoral rotation osteotomy in treating DDH can significantly improve hip function and lower limb motor function,and prognosis is better.

关 键 词：儿童发育性双侧髋关节脱位 股骨近端旋转截骨术 髋关节功能 

分 类 号：R684.7[医药卫生—骨科学]