Salter骨盆截骨及植入物内固定治疗儿童发育性髋关节脱位的中长期随访  

Medium-and long-term follow-up of Salter pelvic osteotomy and implant fixation for children with developmental hip dislocation

作　　者：刘永裕[1] 徐景利 林天烨 吴峰 沈楚龙[1] 熊冰朗 邹启昭 赖启忠 张庆文[3] Liu Yongyu;Xu Jingli;Lin Tianye;Wu Feng;Shen Chulong;Xiong Binglang;Zou Qizhao;Lai Qizhong;Zhang Qingwen(Foshan Traditional Chinese Medicine Hospital,Foshan 528000,Guangdong Province,China;First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510080,Guangdong Province,China;Department of Orthopedics,First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510080,Guangdong Province,China)

机构地区：[1]佛山市中医院,广东省佛山市528000 [2]广州中医药大学第一临床医学院,广东省广州市510080 [3]广州中医药大学第一附属医院关节骨科,广东省广州市510080

出　　处：《中国组织工程研究》2021年第15期2380-2384,共5页Chinese Journal of Tissue Engineering Research

基　　金：广东省中医药局科研项目(20201335),项目负责人:刘永裕。

摘　　要：背景:儿童发育性髋关节脱位是一种临床常见的儿童骨科髋关节疾病,Salter骨盆截骨治疗此病的短期随访效果满意,目前国内尚缺少中长期的临床随访研究。目的:探究Salter骨盆截骨治疗儿童发育性髋关节脱位的中长期随访效果及并发症。方法:回顾性分析广州中医药大学第一附属医院2010年1月至2015年3月收治的发育性髋关节脱位患儿65例(70髋),采用切开复位、Salter骨盆截骨或Salter骨盆截骨联合股骨近端截骨(锁定加压钢板固定)治疗。按Tonnis分度:Ⅰ度10髋,Ⅱ度17髋,Ⅲ度12髋,Ⅳ度31髋。观察患儿术前及术后中心边缘角、髋臼指数、Sharp角、髋臼深度,术后疗效采用Mckay功能标准及X射线片Severin标准评定。结果与结论:①65例患儿均获得随访,随访时间5.1-10.2年;②患儿术后髋臼指数及Sharp角均较术前明显减小,中心边缘角、髋臼深度均较术前明显增大,差异均有显著性意义(P<0.05);③术后末次随访,按Mckay功能评定标准,优良率为97%;按X射线片Severin评定标准,优良率为90%;④3例患儿出现患侧股骨头坏死,1例患儿出现髋关节再脱位,1例患儿出现股骨近端畸形,1例患儿出现患侧肢体感觉异常;⑤提示Salter骨盆截骨联合股骨近端截骨治疗儿童发育性髋关节脱位中长期随访临床疗效满意,可有效改善患儿髋臼覆盖,提高髋关节功能。BACKGROUND:Developmental dislocation of the hip in children is a common clinical orthopedic hip disease in children.The short-term follow-up effect of Salter pelvic osteotomy is satisfactory.At present,there is still no medium-and long-term clinical follow-up research in China.OBJECTIVE:To explore the medium-and long-term clinical effects and complications of Salter pelvic osteotomy in the treatment of developmental hip dislocation in children.METHODS:A retrospective analysis of 65 cases(70 hips)of children with developmental hip dislocation admitted from January 2010 to March 2015 in First Affiliated Hospital of Guangzhou University of Chinese Medicine was performed with open reduction,Salter pelvic osteotomy or Salter pelvic osteotomy combined with femur proximal osteotomy(locking compression plate fixation)treatment.According to Tonnis scale,there were degree I in 10 hips,degree II in 17 hips,degree III in 12 hips,and degree IV in 31 hips.Preoperative and postoperative central margin angle,acetabular index,Sharp angle and acetabular depth were observed.The postoperative efficacy was evaluated by McKay function standard and Severin standard of X-ray films.RESULTS AND CONCLUSION:(1)All 65 patients were followed up for 5.1-10.2 years.(2)The postoperative acetabular index and Sharp angle were significantly lower than those before the operation;and the central margin angle and acetabular depth were significantly increased compared with the preoperative data.The differences were statistically significant(P<0.05).(3)In last follow-up after operation,according to Mckay functional evaluation criteria,the excellent and good rate was 97%.According to the final X-ray Severin evaluation standard,the excellent and good rate was 90%.(4)Necrosis of the affected femur occurred in three patients,relocation of the hip in one patient,proximal femoral deformity in one patient,and sensory abnormalities in the affected limb in one patient.(5)The Salter pelvic osteotomy for children with developmental dislocation of the hip has a sat

关 键 词：骨 骨盆 髋关节 SALTER骨盆截骨 发育性髋关节脱位 儿童 复位 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]