摘要
目的 婴幼儿髋关节发育不良（ｄｅｖｅｌｏｐｍｅｎｔａｌ ｄｙｓｐｌａｓｉａ ｏｆ ｔｈｅ ｈｉｐ，ＤＤＨ）目前最有效、最简捷的方法是采用闭合复位治疗。通过对３周岁以下不同年龄段、单侧ＤＤＨ患儿闭合复位治疗结果进行分析，探讨年龄因素对ＤＤＨ闭合复位治疗疗效及预后的影响。方法自１９８２～１９９６年采用闭合复位治疗３周岁以下ＤＤＨ４１３例（共５４５髋），随机选用＜１周岁、１～２周岁、＞２周岁的单侧完全性ＤＤＨ各 ３０例。测定（量）各病例复位前及复位后 ６、１２、２４个月患侧、正常侧髋臼指数（ｔｈｅ ａｃｅｔａｂｕｌａｒ ｉｎｄｅｘ，ＡＩ）、髓臼指数深宽比［ｔｈｅ ｒａｔｉｏ ｏｆ ｄｅｐｔｈ ｔｏ ｗｉｄｔｈ ｏｆ ＡＩ，ＡＩ（Ｄ／Ｗ）］和治疗后１２、２４个月股骨头中心距离差数百分比（ｃｅｎｔｒｅ－ｈｅａｄ ｄｉｓｔａｎｃｅ ｄｉｓｃｒｅｐａｎｃｙ， ＣＨＤＤ）。结果 各年龄组单侧 ＤＤＨ经闭合复位治疗后２４个月时，各组患侧髓臼与正常侧髓臼 ＡＩ差值中位数：＜ １岁组 ４°，１～ ２岁组 ５． ５°，＞ ２岁组８°患侧髋臼与正常侧髓臼ＡＩ（Ｄ／Ｗ）间平均差值：＜１岁组２．６０％，１－２岁组５．２５％，＞２岁组１２．０３％。各组ＣＨＤＤ差值中?
To study the relationship between the age of the patients undergone closed reduction and the development of the acetabulum in patients with developmental dysplasia of the hip (DDH). Methods From 1982 to 1996 a total of 413 cases(545 hips) of DDH under 3 years of age were treated with closed reduction. Three groups each consisting of 30 cases of unilateral complete DDH were randomly selected for this study. Group 1 belonged to the age range of one year, group 2, 1-2 years, and group 3, over 2 years. Before the reduction and 6, 12, 24 months after closed reduction, data of the acetabular index (Al), ratio of depth to width of AI[AI (D/W) ] of the lesional and normal acetabulum and the 12, 24 months centre-head distance discrepancy(CHDD) were obtained by measurements. Results 24 months after the treatment, the difference of AI between the abnormal and normal acetabulum were: 4° in group l, 5. 5° in group 2, and 8° in group 3. The average difference of AI of the abnormal and the normal acetabulum (D/W) were: 2. 60% in group 1, 5. 25% in group 2, and 12. 03% in group 3. The average difference of CHDD was: 2% in group 1, 3% in group 2, and 1% in group 3. Conclusion During the treatment of DDH with closed reduction in the age range of under 3 years, the AI of the lesional acetabulum decreased in each group and the results were closely related with the basic figure before the commencement of the treatment, the AI of the lesional acetabulunm AI(D/W) increased in each group, apparently there is a relation with the basic figures as well as a linkage with the age factor. In patients of less than 2 years old, there was a relative larger decrease of CHDD, in cases of more than 2 years of age the change of CHDD was not obvious. There is still a question for using CHDD ≤6% as a standard of judgement for the unilateral DDH following treatment for 12 months. The application of CHDD ≤ 9% as the judgement factor seemed to be more in concert with results of practical clinical observations.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第6期329-332,共4页
Chinese Journal of Orthopaedics
