18~24月龄Tonnis Ⅲ、Ⅳ度发育性髋关节发育不良的手术疗效分析  

Surgery for Tonnis type Ⅲ and Ⅳ developmental dysplasia of the hip in 18-24-month-old children

作　　者：李大进 秦海辉 高强 张彬 甄允方[2] LI Da-jin;QIN Hai-hui;GAO Qiang;ZHANG Bin;ZHEN Yun-fang(Department of Orthopaedics,Xuzhou Children s Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 211000,China;不详)

机构地区：[1]徐州医科大学附属徐州儿童医院骨二科,江苏徐州221000 [2]苏州大学附属儿童医院骨科,江苏苏州215000

出　　处：《中国临床研究》2022年第10期1376-1381,共6页Chinese Journal of Clinical Research

摘　　要：目的 评价单纯切开复位术(OR)、切开复位+Salter骨盆截骨术(OR+SIO)、切开复位+Salter骨盆截骨+股骨截骨术(OR+SIO+FO)在治疗18~24月龄T9nnisⅢ、Ⅳ度发育性髋关节发育不良(DDH)患儿中的短期疗效。方法 回顾性分析2015年1月至2018年1月徐州市儿童医院初次治疗的18~24月龄T9nnisⅢ、Ⅳ度DDH患儿47例(56髋)的临床资料。通过测量髋臼指数(AI)、中心边缘角(CEA),统计残余髋臼发育不良(RAD)发生率,根据Severin影像学评级标准和Mckay功能评级标准进行疗效评定,根据Kalamchi-MacEwen标准分型评定X线片是否有股骨头坏死(AVN)。结果 47例患儿平均随访(30.98±1.07)个月。OR+SIO+FO组AI改善值高于OR组,差异有统计学意义(P<0.05)。OR+SIO组、OR+SIO+FO组CEA角大于OR组,差异有统计学意义(P<0.05)。三组RAD发生率、Severin优良率、McKay髋关节功能评价及AVN率比较差异无统计学意义(P>0.05)。结论 三种手术方式均可获得较好的短期预后。但切开复位+Salter骨盆截骨+股骨截骨术在AI及CEA角的改善方面效果更好。Objective To evaluate the short-term efficacy of open reduction(OR),OR and Salter innominate osteotomy(OR+SIO) and OR,SIO and femoral osteotomy(OR+SIO+FO) in the treatment of T9 nnis type Ⅲ and Ⅳ developmental dysplasia of the hip(DDH) of 18-24-month-old children.Methods A retrospective analysis was conducted on the clinical data of 47 children(56 hips) of 18-24-month-old with T9 nnis type Ⅲ and Ⅳ DDH treated in Xuzhou Children’s Hospital from January 2015 to January 2018.The incidence of residual acetabular dysplasia(RAD) was obtained by measuring acetabular index(AI) and center edge angle(CEA).The therapeutic efficacy was evaluated according to Severin imaging evaluation and Mckay classification of the hip joint function.Kalamchi-MacEwen classification was used to assess avascular necrosis of fomoral head(AVN) on X-ray films.Results The average follow-up was(30.98±1.07) months for 47 children.There was a significant difference in AI index between OR group and OR+SIO+FO group(P0.05).Conclusion In the treatment of T9 nnis type Ⅲ and Ⅳ DDH in 18-24-month-old children,the three different surgical methods can obtain a good short-term prognosis.However,the operation of open reduction combined with Salter pelvic osteotomy and femoral osteotomy has a better effect in improving AI and CEA.

关 键 词：发育性髋关节发育不良 切开复位 SALTER骨盆截骨术 股骨截骨术 18~24月龄 疗效 

分 类 号：R726.8[医药卫生—儿科]