摘要
目的 探讨全髋置换术治疗髋关节发育不良（DDH）的手术方法并评价其临床疗效。方法 12例DDH患者根据Crowe分型：Ⅰ型2例，Ⅱ型4例，Ⅲ型4例，Ⅳ型2例。全部采用Biomet全髋假体置换。髋臼假体均为生物型固定，股骨假体除2例骨水泥固定，其余为生物型固定。3例髋臼重建利用自体股骨头于髋臼前外方植骨造盖，9例于真臼水平将髋臼内移；3例股骨重建于转子下截骨短缩并纠正前倾；Ⅲ、Ⅳ型DDH行关节周围软组织松解。结果 患者术后均未出现坐骨神经麻痹、下肢深静脉栓塞、切口感染及早期人工关节脱位等并发症。肢体延长最多4．8cm，平均2．8cm。随访6个月-2年，Harris髋关节评分由术前平均40．7分提高到84．5分，未发生人工关节脱位或假体松动。结论 对有症状的DDH或强烈要求改善步态的年轻患者，全髋置换术是一种有效的治疗方法。
Objective To study the surgical intervention of developmental dysplasia of hip （DDH） with total hip arthroplasty （THA） and to evaluate its clinical results. Methods 12 cases of DDH were treated with THA. According to Crowe classification, there were 2 Ⅰ ,4 Ⅱ ,4Ⅲand 2Ⅳ. All of cups were implanted cementlessly. Three acetabulums were reconstructed with bulk femoral head autograft, and the others＇ cups were medialized at the anatomic height. Subtrochanteric shortening osteotomies were performed for femoral reconstruction in 3 cases. Except for two old patients, the femoral stems were cementless. Considerable soft tissue releasing around involved hip was performed in cases of Group Ⅲ and Group Ⅳ. Results There were no complications such as sciatic nerve palsy, deep vein thrombosis, infection of incision and early dislocation of artificial joint. The mean limb lengthening was 2. 8 cm with rang 0 - 4. 8 cm. The follow-up period ranged from six months to two years. The mean Harris＇ hip score increased from preoperative 40. 7 to postoperative 84.5, and there were no dislocation and prosthetic loosening at the last followup. Conclusions THA is an effective solution for young patients suffering from symptomatic DDH or with strong desire to improve their gait.
出处
《临床骨科杂志》
2006年第2期103-105,共3页
Journal of Clinical Orthopaedics
关键词
髋关节发育不良
全髋置换术
developmental dysplasia of hip
total hip arthroplasty
