摘要
目的 探讨髋关节发育不良的全髋关节置换术的手术要点和术后疗效。方法 25例（28髋）根据CroweX线分型，Ⅰ型14例，Ⅱ型7例，Ⅲ型和Ⅳ型各2例。髋臼旋转中心的重建方法包括标准的全髋关节置换术、结构性自体植骨和髋臼旋转中心内移。恢复下肢长度的方法包括术中彻底切除挛缩的关节囊和纤维瘢痕组织并酌情进行软组织松解。随访内容包括：①Harris评分；②X线测量双下肢长度差和髋臼旋转中心位置。结果 所有病例平均随访28．5个月，Harris评分由术前的平均43分（18～72分）升高至91分（79～100分）。所有病例髋臼旋转中心都恢复正常。术前双下肢长度差为0．5～5．5cm，术后双下肢长度差为-0．4～0．9cm。结论 髋关节发育不良的全髋关节置换术中，除了标准的髋臼重建方法之外，结构性植骨和髋臼旋转中心内移可有效恢复髋臼旋转中心的高度。术前详细的计划，术中彻底切除挛缩的关节囊和纤维瘢痕组织并酌情进行软组织松解有助于恢复下肢长度。
Objective To study the surgical procedure and its postoperative effectiveness of total hip arthroplasty （THA） for treatment of developmental dysplasia of hip （DDH）. Methods Of 25 patients, according to Crowe classification, 14 were type Ⅰ, 7 type Ⅱ, 2 type Ⅲ and 2 type Ⅳ. The reconstruction methods for acetabular rotation center included standard THA, structural autografting and medialization of acetabular rotation centers. The leg length discrepancies were corrected by meticulous preoperative evaluation, complete relief of contracted capsule and fibrous scar intraoperatively. The follow - up contents included Harris hip scoring system, leg length discrepancy and acetabular rotation center studied by X - ray. Results All the patients were followed up for 28.5 months on average. Harris score increased from 43 （18-72） preoperativelY, to 91 （79-100） postoperatively. The acetabular rotation centers were restored in all patients. The leg length discrepancies were 0.5 - 5.5 cm preoperatively and - 0.4 - 0.9 cm postoperatively respectively. Conclusion Besides standard THA, structural autografting and medialization of acetabular rotation center can effectively restore acetabular rotation centers. The leg length discrepancies can be corrected by meticulous preoperative evaluation and intraoperative relief of contracted capsule and fibrous scar.
出处
《中国骨与关节损伤杂志》
2006年第12期962-964,共3页
Chinese Journal of Bone and Joint Injury
关键词
髋关节
置换术
发育不良
Hip joint
Total hip arthroplasty
Developmental dysplasia
